Careful fixation of the pacemaker generator to the venous entry site within the subcutaneous pocket may prevent extreme intracardiac coiling of the catheter.
May warrant attention to secure generator fixation; leaves open optimal techniques pending larger studies.
We report an unusual complication of transvenous pacing: extreme coiling of a pacemaker catheter, which formed a redundant, twisted loop protruding into the right ventricular outflow tract. This may be a result of "twiddling" (rotation) of the pacemaker generator by the patient and/or inadequate fixation of the catheter at the venous entry site. Careful fixation of the generator to the venous entry site within the subcutaneous pocket may prevent such a complication.
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Kouba et al. (1985) studied this question.
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