Key result
Relocating a dislodged left ventricular lead masked by anodal capture successfully shortened the QRS duration in a 78-year-old man.
Case Report (n=1)
Anodal capture can mask left ventricular lead dislodgement by maintaining pacing thresholds, highlighting the importance of imaging when dislodgement is suspected.
Imaging warranted if LV lead dislodgement suspected despite stable thresholds; single case leaves open generalizability to CRT optimization.
A 78-year-old man was implanted with a cardiac resynchronization therapy defibrillator. One month later, chest X-ray and electrocardiography suggested left ventricular (LV) lead dislodgement. However, the LV lead pacing threshold obtained by a programmer was unchanged because anodal capture had developed, which made it difficult to confirm the LV lead dislodgement. Radiographs obtained in the catheterization laboratory revealed that the tip of the LV lead had dislodged into the right atrium. The LV lead was relocated into another lateral coronary vein. Electrocardiography showed the QRS duration to be shorter than prior to this revision.
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Kashiwase et al. (2011) conducted a case report in Left ventricular lead dislodgement (n=1). Left ventricular lead relocation was evaluated on QRS duration. Relocating a dislodged left ventricular lead masked by anodal capture successfully shortened the QRS duration in a 78-year-old man.
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