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Related Experiment Videos

Programmable multiple pacing configurations help to overcome high left ventricular pacing thresholds and avoid

Osnat Gurevitz1, Eyal Nof, Shemy Carasso

  • 1Heart Institute, Sheba Medical Center, Tel-Hashomer, Israel, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. ossi.gurevitz@sheba.health.gov.il

Pacing and Clinical Electrophysiology : PACE
|January 13, 2006
PubMed
Summary

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Newer cardiac resynchronization therapy (CRT) systems with multiple left ventricular pacing (LVP) configurations effectively manage high LVP thresholds and phrenic nerve stimulation (PNS), improving lead placement and reducing reoperation needs.

Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • High left ventricular pacing (LVP) thresholds and phrenic nerve stimulation (PNS) are common complications of cardiac resynchronization therapy (CRT).
  • These issues can necessitate device revision or lead repositioning, increasing patient risk and healthcare costs.

Purpose of the Study:

  • To evaluate the clinical utility of novel CRT systems featuring multiple LVP configurations in managing high LVP thresholds and PNS.
  • To assess the impact of these advanced systems on lead placement success and the need for reoperation.

Main Methods:

  • A study group of 43 patients received CRT systems with multiple LVP configurations (Guidant models H155 and H145).
  • A control group of 49 patients received conventional CRT systems lacking this feature.

Related Experiment Videos

  • Outcomes including LVP thresholds, PNS incidence, and coronary sinus (CS) lead placement success were compared between groups.

    • Main Results:

    • The study group experienced significantly lower rates of acute high LVP thresholds (30% vs. 50%, P=0.03).
    • Phrenic nerve stimulation (PNS) rates were also lower in the study group (12% vs. 24%, P=0.13).
    • Successful CS lead placement in a lateral branch was higher in the study group (95% vs. 77%, P=0.004).

    Conclusions:

    • Multiple LVP configurations in CRT systems are clinically beneficial for overcoming high LVP thresholds and PNS.
    • These systems offer greater flexibility in LV lead placement, potentially reducing the need for reoperation.