Inadvertent identification of the left pericardiophrenic vein following laser lead extraction to guide left ventricular lead placement

Phrenic nerve stimulation (PNS) is a frequent occurrence in patients implanted with a cardiac resynchronization therapy device. We present a case where identification of the left pericardiophrenic vein, which runs alongside the phrenic nerve, was used to guide left ventricular lead placement in order to minimize the risk of PNS.