Cardiology registrars and permanent pacemaker complication rates.

324 © Royal College of Physicians 2014. All rights reserved. Fig 1. (a) and (b) A crush injury a number of months following insertion of a right ventricular pacemaker lead. The lead is transected (arrow). (c) Venogram showing the basilic (BV), cephalic (CV), axillary (AxV) and subclavian (SV) veins. (d) Ultrasound taken at the level shown by the arrow showing the axillary artery (AxA) and vein. The venous nature of the vessel is confi rmed using colour doppler and its compressibility under pressure applied to the probe. infarction in order to avoid delays in reperfusion in patients with a confi rmed diagnosis, but the case presented by the authors demonstrates how an alternative management may be appropriate when emergency echocardiography is available. ■