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A 49-years-old male was admitted for dual-chamber pacemaker replacement following the end of battery life. An additional atrial lead was also to be implanted because of an atrial-lead fracture. After a successful subclavian vein puncture, an atrial screw-in lead was positioned without resistance or difficulty into the right atrium through a seven French sheath. At this moment the patient started having the suffocation and shortness of breath. His systolic blood pressure dropped to 40 mm Hg and systemic oxygen saturation came down to 85%. …
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