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To the editor:According to an investigaion of 417 tertiary hospitals of recent ten years in China,pacemaker implantation has been raising at an average of 11％ per year.Overwhelming majority were received right-side DDD pacemaker.There are a great part need cardiac resynchronization therapy (CRT),especially when they had got cardiomyopathy and/or heart failure.No definite guidelines were for how to upgrade the resynchronization system in these patients.Here we provide one practical way in one case.