Temporary synchronous ventricular pacing as a bridge therapy after CRT-D removal due to lead-related infective endocarditis

We present a case of single-lead temporary synchronous pacing in a patient after cardiovascular implantable electronic device (CIED) removal. A 60-year-old stimulation-dependent patient implanted with cardiac resynchronization therapy and defibrillator (CRT-D) was admitted to the hospital due to heart failure decompensation. Past medical history included chronic heart failure with low ejection fraction (EF), dilated cardiomyopathy, episodes of ventricular arrhythmia, paroxysmal atrial fibrillation (AF) and decompensated mitral regurgitation. The patient developed lead-related infective endocarditis which necessitated complete removal of the implanted system. A spontaneous sinus rhythm (rate ~ 80–100 BPM) was present, but due to complete heart block and ventricular dyssynchrony significant heart failure (HF) decompensation would have occurred without an intervention. Temporary ventricular stimulation was introduced as a bridge therapy until the eradication of the infective endocarditis. Taking advantage of the sinus rhythm, the patient was provided with a Medtronic SEDR01 Sensia DR pacemaker set to VDD mode and connected to the Biotronik Linox Smart ProMRI S DX 65/15, which resulted in single-lead atrial-synchronized ventricular pacing. The lead was introduced through the left subclavian vein into the right ventricular apex. The pacemaker and the proximal part of the lead were externalized outside of the infected pocket in the left subclavian area (Figure 1). Peri-procedure lead parameters