Positional syncope occurring just at the right time in a patient with a permanent pacemaker: A case report.

We present an unusual case of positional syncope occurring years after pacemaker implantation. Syncope was caused by a pacemaker lead fracture, which resulted from subclavian crush syndrome. The syncope occurred incidentally during hospital admission and was timely diagnosed using an integrated approach of history taking, examination findings, device interrogation and radiographic parameters. The patient subsequently underwent lead and device alteration which led to resolution of her symptoms.