Advanced Heart Failure Exacerbated by Discreet Left Ventricular Lead Non-Capture

*Corresponding author: Jon Krathen*, John Costello, Mark Moshiyakhov, Raphael Corbisiero and Kulpreet Barn


This case report illustrates a challenging case of worsening heart failure in a previously well-compensated patient with unclear etiology. Further workup revealed the patient’s cardiac resynchronization therapy-defibrillator (CRT-D) left ventricle (LV) lead was losing capture during positional changes. This case demonstrates the importance of device optimization, as well as electrocardiogram (ECG) monitoring to elucidate possible causes of acute systolic heart failure.


Cardiac resynchronization; cardiac resynchronization therapy (CRT); Systolic heart failure; Lead positioning;
Advanced heart failure.