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Pacemaker syndrome and pseudo-ventricular high threshold after dual-chamber pacemaker replacement.

We report a 60-year-old male patient who presented with pacemaker syndrome. The patient had recent dual-chamber pacemaker replacement. Surface ECG and endocavitary electrograms were compatible with leads connection inversion. Device interrogation showed pseudo-ventricular high threshold. Dual-chamber pacemaker leads inversion in a pacer-dependent patient can lead to life-threatening complications. Industry technicians should not perform device technical assistance when unsupervised by physicians with expertise.