Avoiding pacemaker lead entrapment during PFO closure

We present a case of a patient with a history of cryptogenic stroke and implanted dual‐chamber pacemaker referred for transcatheter closure of patent foramen ovale (PFO). During the procedure ventricular lead of the pacemaker was found to run alongside the PFO. This interrupted correct positioning and deployment of the Amplatzer occluder without sandwiching of the lead. A self‐prepared pigtail catheter with a cut off tip was used to move the lead away from the PFO. Subsequently, an occluder was successfully placed. In conclusion, difficulties in Amplatzer occluder placement in patients with implanted pacemaker may be overcome by a manoeuvre which prevents lead entrapment by the device. © 2008 Wiley‐Liss, Inc.