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What range of pace-sense-compensation should be provided in biventricular pacing systems for heart failure?

  • In cardiac resynchronization therapy (CRT) for heart failure, individualization of the AV delay is essential to improve hemodynamics and to minimize non-responder rate. In patients in sinus rhythm having additional disposition to bradycardia, optimization is necessary for both situations, atrial sensing and pacing. Therefore, echo-optimization is the goldstandard but time consuming. Unfortunately,In cardiac resynchronization therapy (CRT) for heart failure, individualization of the AV delay is essential to improve hemodynamics and to minimize non-responder rate. In patients in sinus rhythm having additional disposition to bradycardia, optimization is necessary for both situations, atrial sensing and pacing. Therefore, echo-optimization is the goldstandard but time consuming. Unfortunately, it depends on the particular CRT systems parameter set if the resulting individually optimal AV delays can be programmed or not. Some CRT systems provide a set of AV delays for DDD operation combined with a set of the pace-sense-compensation to optimize the AV delay in DDD and VDD operation. The pace-sense-compensation (PSC) can be defined by the difference of implant-related interatrial conduction intervals in DDD and VDD operation measured in the esophageal left atrial electrogram. In a cohort of 96 CRT patients we found mean PSC of 59-35ms ranging between 0-143ms. As a consequence, allowing 10ms tolerance, AVD optimization is completely impossible in one of the two modes, VDD or DDD operation, in 34 (35%) or 5 (5%) patients with implants restricting the PSC range to 60ms or 100ms, respectively. Thus, we propose companies to provide CRT systems with programmable pace-sense- compensation between 0ms and 150ms.‚Ķshow moreshow less

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Metadaten
Author:Daisy Gebhardt, Frauke SchmidGND, Frank Weber, Matthias HeinkeGND, Ina Carolin Ennker, Juraj Melichercik, Bruno IsmerGND
Publisher:De Gruyter
Place of publication:Berlin [u.a.]
Year of Publication:2012
Language:English
Parent Title (Multiple languages):Biomedizinische Technik - Biomedical Engineering
Volume:57
Issue:Issue S1-1 Track-Q
ISSN:0013-5585
First Page:384
Last Page:385
Document Type:Conference Proceeding
Institutes:Hochschule Offenburg / Bibliografie
Acces Right:Zugriffsbeschränkt
Release Date:2014/12/05
Licence (German):License LogoEs gilt das UrhG
Note:
BMT 2012, 46. DGBMT Jahrestagung, Jena, 16. - 19. September 2012
URL:https://www.researchgate.net/publication/230826826_What_range_of_pace-sense-compensation_should_be_provided_in_biventricular_pacing_systems_for_heart_failure
DOI:https://doi.org/10.1515/bmt-2012-4159