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Case Reports
. 2014 May 14:2014:bcr2013202948.
doi: 10.1136/bcr-2013-202948.

Positional convulsant syncope in a pacemaker patient following insulation break of the right ventricular lead

Mehdi Ben Lassoued  1 , Makram Baatour  1 , Abdeddayem Haggui  2 , Khaled Lamine  1
Affiliations
Case Reports

Positional convulsant syncope in a pacemaker patient following insulation break of the right ventricular lead

Mehdi Ben Lassoued et al. BMJ Case Rep. .

Abstract

In spite of the advances made in the technology of pacemakers which resulted in a decrease in the incidence of pacemaker lead fracture, the latter remains a potential complication of implanted pacemakers manufactured in the early days. In this report, we present a case of fracture of the unipolar electrode diagnosed by an emergency physician in a patient on a pacemaker for 10 years who presented to the emergency department with positional convulsant syncopes.

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Figures

Figure 1
Figure 1
Critical monitoring: severe bradycardia with non-conducted atrial spikes followed by asystole.
Figure 2
Figure 2
Critical monitoring: spontaneous resumption of a ventricular escape rhythm (wide QRS) at 60 bpm with atrial spikes.
Figure 3
Figure 3
X-ray film performed at the patient's bed: a fractured ventricular lead at the level of the right thoracic outlet (left-handed patient).
Figure 4
Figure 4
Chest X-ray after implantation of a new pacemaker on the left side.
See this image and copyright information in PMC

References

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