Resynchronization of the left ventricular contraction by tailored programming of right and left ventricular pacing

Abstract

A sub-optimal resynchronization is achieved with simultaneous BIV pacing in most patients. A tailored programming of the relative contribution of RV and LV pacing forms the prerequisite for improving CRT results.

Predictors of clinical efficacy of ‘Ablate and Pace’ therapy in patients with permanent atrial fibrillation

“…On the basis of the results of the pilot study,7 normal intra-LV delay was defined as a value ≤41 ms. The method of evaluating the intra-LV delay and optimising CRT has been described previously 7 8. In the patients randomised to the CRT group, the simultaneous biventricular pacing mode was chosen if the intra-LV delay was within the upper normal limit of 41 ms.…”

Cardiac Resynchronization Therapy

“…Optimal cardiac synchrony can often be achieved by programming the excitation of the RV or the LV fi rst (V -V optimization). Brignole et al (2008) demonstrated that IVCD at baseline was 63 ms, and decreased to 44 ms with CRT. Further V -V optimization by programming the RV or LV fi rst resulted in a decrease in the delay to 26 ms.…”

“…Further V -V optimization by programming the RV or LV fi rst resulted in a decrease in the delay to 26 ms. In most cases, the LV is activated before the RV (Brignole et al 2008 ). Since it is not clear which V -V interval will be optimal, repeated testing is required.…”

Optimization of pacing intervals in cardiac resynchronization therapy

“…O náročnosti optimalizace svědčí např. to, že autoři jedné z metod založené na měření dyssynchronie pomocí tkáňově dopplerovských technik považují svoji metodu za poměrně rychlou, neboť optimalizace jednoho pacienta netrvala déle než 60 min [5]. Metod k zjišťování a měření vlivu stimulačních intervalů na hemodynamiku ale existuje celá řada.…”