Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disease where therapy with an internal cardioverter defibrillator (ICD) is frequently indicated, but the use of these devices is often challenged because of sensing dysfunction with low right ventricular sensing amplitude. We present the case of an ARVC patient in whom ICD sensing difficulties were overcome by the implantation of a coronary sinus lead for pacing and sensing.