Left ventricular sensing in cardiac resynchronization devices-opportunities and pitfalls for device programming.

Häberlin, Andreas; Ploux, Sylvain; Noel, Antoine; Chauvel, Rémi; Welte, Nicolas; Marchand, Hugo; Haissaguerre, Michel; Ritter, Philippe; Bordachar, Pierre (2019). Left ventricular sensing in cardiac resynchronization devices-opportunities and pitfalls for device programming. Journal of cardiovascular electrophysiology, 30(8), pp. 1352-1361. Wiley-Blackwell 10.1111/jce.14039

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INTRODUCTION Some cardiac resynchronization therapy (CRT) device manufacturers (Biotronik, Germany; Boston Scientific, United States) have implemented left ventricular (LV) sensing functionality to prevent pacing into the vulnerable phase. Physicians are only partially aware of programming pitfalls related to LV sensing and general programming advice is lacking. METHODS AND RESULTS We provide an illustrative case-series-based review of the variety of potential problems with LV sensing. LV sensing may inappropriately impair CRT delivery due to LV-sensing issues or improper device programming. This can cause beat-wise loss of resynchronization but also ongoing desynchronization. On the other hand, LV sensing provides additional diagnostic information, which may reveal intermittent problems of the LV lead such as capture loss. We summarize the available evidence to provide manufacturer-specific recommendations on device programming and troubleshooting for daily clinical practice. CONCLUSION CRT devices with LV sensing may suffer from impaired resynchronization due to programming pitfalls. If LV sensing is active (nominal setting in Biotronik and Boston Scientific devices), careful lookout for related problems and resynchronization percentage is required. Optimization is mandatory and even deactivation of LV sensing may have to be considered.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship > Cardiac Technology and Implantable Devices
04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Häberlin, Andreas

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1045-3873

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Andreas David Heinrich Häberlin

Date Deposited:

08 Oct 2019 10:14

Last Modified:

24 Oct 2019 11:49

Publisher DOI:

10.1111/jce.14039

PubMed ID:

31231884

Uncontrolled Keywords:

cardiac resynchronization therapy left ventricular lead left ventricular sensing lock-in

BORIS DOI:

10.7892/boris.133743

URI:

https://boris.unibe.ch/id/eprint/133743

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