case_images: PMC11555240_01
case_images: (A) Electrocardiogram demonstrating atrioventricular (AV) paced rhythm, (B) Chest X-ray with posteroanterior and (C) lateral chest views showing pacemaker within right chest with epicardial pacemaker leads with loop around the anterior surface of the heart.
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case_images: An electrocardiogram was performed which showed an atrial and ventricle (AV) paced rhythm with a heart rate of 67 beats per minute (Fig. 1A). Chest X-ray showed right ventricular epicardial lead looped around the left ventricle (Fig. 1, Fig. 1). Computed tomography (CT) revealed EP loop encompassing the heart (Figs. 2A and B).
case_images: Three-dimensional computed tomography showing (A) epicardial pacemaker lead loop around the (A) anterior and (B) posterior surface of the heart (asterixis).
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case_images: Chest X-ray showed right ventricular epicardial lead looped around the left ventricle (Fig. 1, Fig. 1). Computed tomography (CT) revealed EP loop encompassing the heart (Figs. 2A and B).
case_images: Left heart catherization findings with (A) epicardial atrial lead (blue arrow), epicardial ventricular lead (red arrow), atrial pacemaker lead (green arrow), ventricle pacemaker lead (orange arrow), (B) showing compression of the left anterior descending artery (blue arrow), OM1 (red arrow), left circumflex artery (green arrow) by the epicardial lead.
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case_images: RHC findings were consistent with restrictive physiology based on simultaneous and right ventricle and left ventricle pressure monitoring (Fig. 3).
case_images: Right heart catherization with simultaneous left and right ventricualr pressure tracing showing concardant pressure changes (arrows); consistent with restrictive cardiomyopathy.
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case_images: Coronary angiography revealed compression of the left anterior descending artery, first obtuse marginal branch (OM1) and left circumflex artery by the right ventricular epicardial lead (Figs. 4A and B).