PMC2655057_01
Fluoroscopic image in anterioposterior view showing screwed pacing lead at right ventricular apex with an alpha loop in right atrium
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F1
An alpha loop was made in the right atrium so that the lead can not be stretched by its own weight avoiding lead displacement (Figure 1).
X-ray in anterioposterior view showing pacemaker unit lying under rectus sheath with pacing lead going through external iliac vein to inferior vena cava. Pacemaker unit is looking lateral and down  because of patulous abdomen and X ray has been taken in erect posture.
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PMC2655057_01_ipej090108-02.jpg
F2
The lead was then tunneled subcutaneously and connected to the pacemaker (VVIR, Regency 2400L) which was put from the second incision (Figure 2).
PMC2655057_02