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We present a case of a 13-year old patient with partially reversibly post-operative heart block who underwent leadless pacemaker placement. After post-anesthesia wretching/gagging episode she developed device microdislodgement and increased/intolerable capture thresholds. The device was removed and another placed with adequate thresholds for good longevity. BACKGROUND Although emergency medical service- (EMS-) witnessed out-of-hospital-cardiac arrest (OHCA) has a high survival rate and potential for prevention of progression to cardiac
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