It was reported that the patient with this cardiac resynchronization therapy defibrillator (crt-d) was admitted to the hospital with a syncopal episode.A chest x ray analysis was completed and showed the crt-d had moved inferiorly, putting tension on the leads.The right ventricular (rv) lead did not capture at maximum output.A non-bsc left ventricular (lv) lead did not capture the left bundle branch, only the rv septum.The patient developed a pericardial effusion; therefore, a pericardial window procedure was completed.Afterwards, the patient underwent a lead revision, nevertheless a new rv lead was required as the initial rv lead showed mechanical difficulties while being revised.The non bsc lv lead dislodged during the procedure and patient went asystole.Cardiopulmonary resuscitation was performed for a few minutes while a temporary pacing wire was placed.The dislodged non bsc lead was removed, and a new one was placed in the high rv septum.The pocket was closed and discharged.No additional adverse patient effects were reported.
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