case_images: PMC10008109_01
case_images: (a) Right thoracic anatomy and (b) anteroposterior chest X-ray.
case_images: CRIC2023-6646715.001.jpg
case_images: PMC10008109_01_CRIC2023-6646715.001.jpg
case_images: fig1
case_images: DF1, Medtronic, Minneapolis, MN, USA) on the right side connected to a ventricular lead (Saint Jude Medical Durata) with active fixation to the interventricular septum. During follow up, the can glided into the axillary fossa, prompting multiple interventions until a pocket was eventually created by a Plastic Surgeon in the right mammary region (Figure 1).
case_images: ECG at admission.
case_images: CRIC2023-6646715.002.jpg
case_images: PMC10008109_01_CRIC2023-6646715.002.jpg
case_images: fig2
case_images: Coronary angiography in the 30  left anterior oblique (a) and 20  right anterior oblique (b) views, showing compression of the LAD. Of note, in the right anterior oblique view, the implantation site is distal to the heart silhouette, suggesting a very anterior position.
case_images: CRIC2023-6646715.003.jpg
case_images: PMC10008109_01_CRIC2023-6646715.003.jpg
case_images: fig3
case_images: As some evolution was suspected concerning her coronary disease, a coronary artery angiography was performed (Figure 3), showing lack of new stenosis, but a compression of the distal LAD coronary artery at the implantation site of the RV lead.
case_images: Anteroposterior fluoroscopic view showing the final placement of the leads and of the can.
case_images: CRIC2023-6646715.004.jpg
case_images: PMC10008109_01_CRIC2023-6646715.004.jpg
case_images: fig4
case_images: The following day chest X-ray (Figure 4) showed no lead displacement and the ECG revealed satisfactory resynchronization pattern (Figure 5).
case_images: ECG after resynchronization.
case_images: CRIC2023-6646715.005.jpg
case_images: PMC10008109_01_CRIC2023-6646715.005.jpg
case_images: fig5
case_images: The following day chest X-ray (Figure 4) showed no lead displacement and the ECG revealed satisfactory resynchronization pattern (Figure 5).