Is it a procedural complication or something else?
This images are from a patient presenting to the emergency department with palpitation and syncope. She had an ICD implantation a few months ago in another center. Her ECG showed ventricular tachycardia at a rate of 182 bpm. We first thought that programmed rate of VT theraphy zones would be greater than this VT rate. But her X-ray showed lead location outside the heart ?!!! CT images showed the tip of the lead inside the left renal vein!. We decided to revision of this lead. Firstly we engaged the left renal vein with a guiding catheter and inserted to a floppy wire to the vein to use in an emergency setting. Then we openned the pacemaker pocket, took the generator out, inserted a stylet and unscrewed the lead, pulled the lead until right atrium and inserted it to the right ventricular apical septum. Then we gave contrast dye to the renal vein and saw no bleeding. Patient did well the postoperative days.