Described here are seven cases of permanent transvenous pacemakers associated with a pacemaker click. The graphic findings and roentgenographic appearance of the catheter position are discussed. Although these cases appear to represent penetration at least of the right ventricular myocardium by the catheter tip, there was no evidence of pacemaker malfunction in any of the cases. The pacemaker sound per se is therefore not an indication for repositioning of the catheter tip, but it is suggested that the presence of a pacemaker click may be due to malposition of the catheter tip with partial penetration of the right ventricular myocardium.
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