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Europace Advance Access originally published online on January 26, 2009
Europace 2009 11(4):535-536; doi:10.1093/europace/eun394
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

CASE REPORTS

Twiddling in cardiac resynchronization therapy: ‘when length matters’

Miguel A. Arias*, Alberto Puchol, Marta Pachón, Eduardo Castellanos and Luis Rodríguez-Padial

Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Virgen de la Salud, Planta Semisótano, Avda. Barber 30, 45004 Toledo, Spain

We report on a 75-year-old woman who successfully underwent cardiac resynchronization therapy. Two weeks after implantation, right continuous pectoral stimulation appeared. Retraction and dislodgement of the right atrial and right ventricular leads as well as coiling of the three leads around the device generator were observed on chest radiography, but, surprisingly, the left ventricular lead remained unaffected due to its major length to facilitate the manoeuvers of implantation.

* Corresponding author. Tel: +34 637463857, Fax: +34 925265492, Email: maapalomares{at}secardiologia.es


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