This report describes a patient with a 6-year-old pacemaker lead in the left ventricle. Both transthoracic and transesophageal echocardiography unequivocally showed that the lead enters the left ventricle via the foramen ovale and the mitral valve. The patient did not suffer from a thromboembolic event; therefore, we did not proceed with extraction. The importance of this case report is to emphasize the conditions and precautions of proper pacemaker implantation.
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