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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 bothsituations, atrial sensing and pacing.Therefore, echo-optimizationis thegoldstandard buttime consuming. Unfortunately, itIn 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 bothsituations, atrial sensing and pacing.Therefore, echo-optimizationis thegoldstandard buttime consuming. Unfortunately, it depends on the particular CRT systems parameter set if the resulting individually optimal AV delayscan 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 patientswe 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 DDDoperation, 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 withprogrammable pace-sense-compensation between 0ms and 150ms.show moreshow less

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Metadaten
Author:Daisy Gebhardt, Frauke Schmid, Frank Weber, Bruno Ismer
Creating Corporation:BMT 2012, 46. DGBMT Jahrestagung, Jena, 16. - 19. September 2012
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
Release Date:2014/12/05
Licence (German):License LogoEs gilt das UrhG
DOI:https://doi.org/10.1515/bmt-2012-4159