Spontaneous twisting of pacemaker electrodes is a rare complication that can be managed by reimplanting the same electrode after stiffening the lead near the generator.
May allow electrode salvage in twisted pacemaker leads; hypothesis-generating and requires validation before wider use.
We present three cases of an unusual pacing lead aberration occurring at different times after implantation. In the first patient, the electrode was twisted close to the pacemaker, and dislodgment occurred on the 40th postoperative day. In the second case, there was only proximal twisting of the electrode. In the third case the electrode was twisted in two places: proximal to the pacemaker, and distal, within the right atrium. The complication was managed successfully by reimplanting the same electrode after stiffening the lead near the generator with a portion of the stylet.
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Gialafos et al. (1995) studied this question.
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