[Case of epicardial left ventricular pacing lead implantation under general anesthesia in a patient with severe cardiac dysfunction].

An 82-year-old man with severe cardiac dysfunction due to ischemic cardiac myopathy was diagnosed as indication for biventricular pacing. His left ventricular ejection fraction was 22%. Because of difficulty in coronary sinus lead fixation, epicardial lead implantation through a thoracotomy under general anesthesia was scheduled.