Pacing failure due to microdislodgement of ventricular pacing lead detected by home monitoring technology

A 68-year-old woman affected by sick sinus syndrome was implanted with a dual-chamber pacemaker provided by home monitoring technology. After discharge, an increase in ventricular threshold and a high variability of R wave measurements were detected early by the home monitoring system. Manual tests confirmed the presence of pacing and sensing failure and a normal ventricular impedance. The pacing lead integrity and a stable position of the lead tip in right ventricular apex were assessed by chest X-ray. A diagnosis of microdislodgement was made. After a second procedure for ventricular lead repositioning, no further malfunctions were detected.