Completely epicardial implantation of a cardiac resynchronization therapy defibrillator using a minimal invasive approach.

We report the case of a successful completely epicardial implantation of a cardiac resynchronization defibrillator using a minimal invasive approach in a 55-year-old patient with dilated cardiomyopathy and a history of three cardiac surgical procedures of the aortic root, the ascending aorta and the aortic arch. Due to a chronic Q fever the patient was regarded unsuitable for a transvenous implantation.