KEY TEACHING POINTS

•The response to cardiac resynchronization therapy (CRT) is determined by the position of the left ventricular lead. •Before the introduction of the Attain Stability, a novel left ventricular active fixation lead, CRT was a compromise between cardiac veins anatomy, capture threshold, and phrenic nerve stimulation. With the Attain Stability, now it is only important to identify the target area. It is very easy to reach the area, provides optimal stability and good pacing capture thresholds, and avoids phrenic nerve stimulation. •In this case, the Attain Stability lead was the only possible lead for optimal lead placement.