"Cold can for a hot case": use of a coronary sinus shocking lead in association with cold can to achieve successful defibrillation.

Attaining an adequate defibrillation threshold is critical in the functioning of an implantable cardioverter-defibrillator. This is achieved in a majority of implants but in those where this does not occur, reprogramming, lead repositioning, and ultimately placement of a subcutaneous array lead may be necessary.