Prosthetic tricuspid valve is an obstacle to implant cardiac devise. Cardiac Resynchronization therapy is one of the most popular therapies for heart failure patients these days. We present this case of prosthetic tricuspid valve and left ventricular dysfunction which we overcome the problem by implanting two leads to coronary sinus branches. Patient improved in few months of follow up.
Keywords: CRT; Heart Failure; Tricuspid Valve.