Laser extraction of pacemaker lead traversing a patent foramen ovale and the mitral valve

Left ventricular lead misplacement is an infrequent complication of pacemaker or defibrillator lead insertion. It most commonly occurs through defects in the interatrial septum. Although patients may remain asymptomatic, the most common clinical complication is a thromboembolic event. Percutaneous technology has been described to safely remove misplaced leads. We present a case of a patient with a pacemaker lead in the left ventricle through a patent foramen ovale that was successfully extracted using excimer laser technology.