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An 83-year-old female presented with syncope. She was found to be in complete heart block with an escape rhythm of 40 bpm. Following admission she remained haemodynamically stable with no prolonged pauses; she was therefore listed for pacemaker implantation the next morning.
Initial attempts at venous access were right-sided due to recent left shoulder …
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; not externally peer reviewed.