An 81-year-old woman was admitted to our cardiology clinic with episodes of atypical chest pain.She had a personal history of hypertension and had undergone implantation of a VVIR pacemaker (in a subcutaneous pocket at theright upper side of her thorax) fifteen years before at another institution, because of atrioventricular conduction disturbances (Figure 1DI).Seven years before, the pacemaker was re-implanted and substituted by a DDDR device because of skin erosion and inserted in a lower subcutaneous pocket, also in the right side of the thorax, without lead removal (Figure 1DII).