PMC6342727_01
Fluoroscopic positioning of leads and generators. A: Right atrial and right ventricular (RV) lead position. Note RV defibrillation lead is mid septal and not apical. B: Anterior-posterior view of left lung field with generator moved to an axillary position. A phantom generator (black arrow) was placed on the skin over the site of the previous generator position. C: Left anterior oblique 45-degree view of the generators and leads.
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Because of the fact that the ICD lead was not in an apical position (Figure 1A), the ongoing use of flecainide, and echocardiographic evidence of enlargement of the right ventricle (diameter increased from 2.9 cm to 4.3 cm), he underwent DFT testing during generator replacement (Medtronic model DDMC3D4). The new position of the device compared to initial position is shown in Figure 1B (anterior-posterior) and Figure 1C (left anterior oblique 45 degrees).