A rare cause of syncope in patients with situs inversus totalis and corrected transposition of the great arteries: Very late lead perforation.

Situs inversus c-TGA refers to a complex anatomical malformation. The risk of developing AV block increases by 2% per year. Pacemaker lead perforation is a rare but serious complication after pacemaker implantation and that develops more than 1 month is defined as late lead perforation. Here, we presented a case of very late lead perforation that occurred 5 years later after pacemaker implantation in a patient with congenital heart disease who had pacemaker due to AV block. Even in the late period, this complication should be kept in mind in patients with a pacemaker who present with syncope.