Percutaneous extraction of an overcoiled temporary pacemaker lead using a femoral introducer sheath

Temporary pacemaker placement is essential for the acute management of high-grade AV block, particularly in scenarios with impending hemodynamic compromise where pharmacological measures (e.g., atropine or isoproterenol) prove insufficient or contraindicated (1,2). Although the most commonly reported complications include lead displacement, perforation, or local infection, the formation of knots or overcoiling within the heart is seldom described (7–10). When overlooked or improperly managed, this phenomenon can lead to severe hemodynamic consequences (3).