A Progressive Prolapse of a Left Ventricular Pacing Lead into the Right Ventricle in a Patient with Cardiac Resynchronized Therapy

This case report illustrated a progressive prolapse of a left ventricular (LV) lead into the right ventricle and pulmonary artery for more than 2 years in a 33-year-old woman with a history of congestive heart failure secondary to nonischemic cardiomyopathy and left bundle branch block that underwent implantation of an implantable cardioverter defibrillator with cardiac resynchronized therapy. This phenomenon’s mechanism might have been reverse reel or ratchet syndrome. This phenomenon could be missed because the LV lead tip was fixed with unchanged pacing measurements and the course of the thin LV lead could not be easily identified on chest radiographs.