Chest x- ray in the anterior and lateral view after the original CRT- ICD implantation (2 a- b) and after revision of the ICD lead (2 c- d). Atrial and CS electrodes remained unchanged. During revision the malplaced ICD electrode was removed and replaced in the RV. The chest x-ray after first implant was graded normal by routine judgement. In retrospective, the curve at the atrial level and the posterior orientation of the ICD lead may indicate passage of the foramen ovale and misplacement in the LV.