ABSTRACT Late rising in pacing threshold is an uncommon complication of permanent pacing. Treatment with high dose systemic steroid could spare the patient another procedure. We report a case of late rising pacing threshold that responded to high dose sys-temic steroid which lowered the pacing threshold to one volt, then rose again to around 2 volts.
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nullZaky, H. , El Zein, H. and Al-Mulla, A. (2011) Late rising right ventricular pacing lead threshold four yearsafter implantation of a dual chamber pacemaker. Open Journal of Internal Medicine, 1, 1-3. doi: 10.4236/ojim.2011.11001.
 Beanland DS, Akyureckli Y, Keon WJ: Prednisolone in the management of exit block, proceeding of the sixth world symposium on cardiac pacing, Montreal, Quebec, October 2-5, 1979, P 18-3.
 Risby O, Meibom J, Nyboe I, Schuller H :the influence of prednisolone on pacemaker threshold (abstract). Pacing clinical electrophysiol 4; A-68, 1981.
 Nagatomo Y, Ogawa T, et al: Pacing failure due to markedly increased stimulation threshold two years after implantation: Successful management with oral prednisolone. A case report. Pace 12: 1034, 1989.
 PrestonTA, Judge RD, Lucchesi BR, et al: Myocardial threshold in patients in patients with artificial pacemakers. Am J Cardiol 18: 83, 1966.
 5-A Ferraro, A.Sabena Masi, A.Mazza. Increased stimulation threshold in a patient with autoimmune disease: successful management with oral prednisolone and azathioprine. EP Europace 11:4, 527-529, 2009.