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Cardioembolic Stroke in Patients with Patent Foramen Ovale and Implanted Cardiac Leads


  • Disclosures: None.

Address for reprints: Samuel J. Asirvatham, M.D., Professor of Medicine, Division of Cardiovascular Diseases, 200 First Street SW, Rochester, MN 55905. Fax: 507-255-2550; e-mail:


Implanted cardiac devices, including pacemakers, defibrillators, and resynchronization devices, are known to develop thrombus on their intravascular leads. Patent foramen ovale (PFO) occurs in approximately one-quarter of the adult population. It is unclear whether paradoxical cardioembolism and clinically relevant stroke occur in patients with implanted cardiac leads and PFO. We present a case series of four patients with cardioembolic stroke, presumed to arise from intravascular cardiac leads and associated PFO that required device closure of the PFO.

(PACE 2013; 36:50–54)