Hemodynamic Benefit of Multiple Programmable Pacing Configurations in Patients with Biventricular Pacemakers

Abstract

Changing the LVS configuration changes hemodynamic function in some CRT system recipients.

Improvement in Hemodynamic Response Using a Quadripolar LV Lead

“…These findings tally with those obtained in two previous studies. 16,17 The first one, carried out in 14 patients, found significant differences between four and six possible configurations in the CO (4.6 ± 1.4 L/min vs 3.9 ± 1.4 L/min; P < 0.001) and myocardial performance index (0.40 ± 0.29 vs 0.64 ± 0.48; P = 0.003). 16 The second study, carried out in 19 patients with a quadripolar lead, found significant acute hemodynamic differences, determined by invasive estimation of dP/dt max between the best and worst pacing vector.…”

“…16,17 The first one, carried out in 14 patients, found significant differences between four and six possible configurations in the CO (4.6 ± 1.4 L/min vs 3.9 ± 1.4 L/min; P < 0.001) and myocardial performance index (0.40 ± 0.29 vs 0.64 ± 0.48; P = 0.003). 16 The second study, carried out in 19 patients with a quadripolar lead, found significant acute hemodynamic differences, determined by invasive estimation of dP/dt max between the best and worst pacing vector. 17 In the QUARTO study, we observed that in over half of the patients the best CO was obtained with configurations only available with the quadripolar lead ("nontraditional configurations").…”