Twiddling in cardiac resynchronization therapy: 'when length matters'

We report on a 75-year-old woman who successfully underwent cardiac resynchronization therapy. Two weeks after implantation, right continuous pectoral stimulation appeared. Retraction and dislodgement of the right atrial and right ventricular leads as well as coiling of the three leads around the device generator were observed on chest radiography, but, surprisingly, the left ventricular lead remained unaffected due to its major length to facilitate the manoeuvers of implantation.