TY - JOUR T1 - A case of difficult RV lead placement JF - Heart JO - Heart SP - 434 LP - 435 DO - 10.1136/heartjnl-2013-305263 VL - 100 IS - 5 AU - Amal Muthumala AU - Neil Herring AU - Kelvin Wong Y1 - 2014/03/01 UR - http://heart.bmj.com/content/100/5/434.abstract N2 - A 65-year-old man with ischaemic cardiomyopathy (EF 23%), NYHA class II–III heart failure symptoms and ECG showing LBBB with QRS duration of 150 ms underwent implantation of a Cardiac Resynchronisation Therapy Defibrillator (CRTD). The procedure was uneventful, and the pacing threshold and R wave amplitude during testing of the active dual coil lead were satisfactory. Figure 1 showed a PA fluoroscopic image (1A), 12-lead ECG recorded during pacing from the defibrillator lead (1B), and injury current recording from the pacing system analyser (1C). Where is … ER -