It was reported that the patient with this left ventricular (lv) lead had developed phrenic nerve stimulation sometime after implant.A multiple reprogramming was performed but the issue was persistent and inconsistent, hence, the lead was turned off some time ago.Now that the patient needs lv pacing, a system revision was attempted.However, the patient had complete superior vena cava (svc) occlusion and could not get wire through the existing lead to remove it.Since there were good margins between the stimulation threshold and pacing threshold with tip to ring vector of the existing lead, the lv lead was just reprogrammed to pace based on that margins.Furthermore, the patient has had no stimulations experienced after the surgery.The lead remains in service.No adverse patient effects were reported.
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