Ticket for admission: unexplained syncopal attacks in patients with cardiac pacemaker

A case of pacemaker syncope associated with cardiorespiratory arrest is reported. This patient was seen three times in emergency departments before finally being admitted for evaluation. Ventricular tachycardia due to pacemaker firing in the T-wave on electrocardiogram was observed. The patient was managed with cardioversion, temporary pacing and replacement of the generator and wire. The dislodgement of the pacemaker wire was confirmed at operation. Patients with pacemaker implants who present with unexplained syncopal attacks should be admitted to the hospital for monitoring, diagnostic work-up, and treatment.