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Peri- and post-procedural ventricular tachycardia (VT) is a rare complication after leadless pacemaker implantation and requires an individualized approach. In this case report we describe the management of VT in a patient with subendocardial scarring due to prior coronary artery disease who presented with monomorphic VT the day after implant. The etiology was found to be related to the novel ventricular activation wavefront by ventricular pacing which induced a reentrant circuit dependent on pre-existing myocardial substrate. Invasive
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