CRT after Lead Extraction

When biventricular device reimplantation is necessary, we usually follow the same rules that we use in other pacing settings. Particular attention must be paid to patients with a hemodynamic dependency (to evaluate for same-day contralateral reimplantation) [15]. It is also very important to reassess the real need for CRT in patients undergoing coronary sinus (CS) lead extraction in particular, nonresponders will not be candidates to reimplantation if the previous site of pacing is considered correct, spontaneous QRS complex is narrow. 

Fig 9 2 Using a right-sided approach, the electrophysiological catheter is directed to the lateral wall of the right atrium (a) successful cannulation of the coronary sinus in the same patient (b) 

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