A 72-year-old woman was admitted to our hospital due to severe heart failure (HF) with reduced left ventricular ejection fraction (LVEF; 33%) and ventricular tachycardia. Since LV lead implantation for CRT-D failed, an ICD lead was implanted in the right ventricle (RV). Several days after the implantation, right HF was significantly exacerbated. Echocardiogram showed severe RV dilatation and the obstruction of tricuspid valve motion by the ICD lead causing massive TR. Since the withdrawal of the ICD lead failed to decrease TR, CRT-D implantation was performed with the relocation of ICD lead and successful LV lead implantation. Thereafter, HF was improved. Relocation of intracardiac lead should be immediately considered for acute right HF in addition to the conservative treatment for left HF in patients with severe LV dysfunction.
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