The case of a patient with pacemaker-induced cardiomyopathy in whom left ventricular (LV) function was dramatically improved after switching the ventricular pacing site from the right ventricular apex to the LV free wall via a left mini thoracotomy due to pacemaker-associated infective endocarditis (PAIE) is presented. Our experience suggests that a surgically implanted epicardial LV lead on the LV lateral wall can be a good alternative pacing site that preserves LV function, especially in patients with PAIE.