Twists in an endocardial lead indicate an oversized pulse generator pocket, which can lead to pacemaker failure.
Prompts pocket size checks in lead malfunction; case report leaves open generalizability and need for prospective validation.
A new complication of transvenous pacing is described. Twists developing in an endocardial lead indicate that the pulse generator pocket is too large. Pacemaker failure because of electrode dislodgement or lead fracture will ensue.
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Tegtmeyer et al. (1976) studied this question.
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