Resynchronization with left ventricle lead placement through the foramen ovale.

Left ventricle (LV) lead placement in a coronary sinus branch for cardiac resynchronization therapy may fail because of anatomical variants, phrenic nerve stimulation, and/or lead instability. We report a case of successful resynchronization from a lead inserted from the left subclavian vein and positioned through a patent foramen ovale (PFO). In conclusion, endocardial LV lead insertion through a PFO enables effective resynchronization delivery without the risks associated with a thoracotomy or atrial transseptal puncture.