Left ventricle automatic pacing threshold management in CRT systems: A comprehensive review.
Franco ZoppoGiulia GagnoPublished in: Journal of cardiovascular electrophysiology (2020)
Modern cardiac resynchronization therapy (CRT) device-based threshold detection enables capture management and voltage output adjusting to combine consistent left ventricular (LV) pacing with acceptable battery drainage. The current technologies available for LV capture automatic confirmation in most cases require the evoked response, as well as "LV pace to right ventricular sense" algorithms. The LV pacing percentage counter may overestimate the CRT delivery which may be reduced due to pacing inhibition (by sensed LV activation) or inadequate capture due to subthreshold current or pacing into refractory tissue. Moreover, the LV threshold at implant and its behavior over time (as a marker of electrical viability) and the ineffective CRT issues (subthreshold stimulation or concealed loss of capture) are discussed. The purpose of the present review is to explore these new challenges regarding LV pacing automatic management.
Keyphrases
- cardiac resynchronization therapy
- left ventricular
- heart failure
- machine learning
- deep learning
- hypertrophic cardiomyopathy
- mitral valve
- acute myocardial infarction
- aortic stenosis
- pulmonary artery
- neural network
- atrial fibrillation
- coronary artery
- aortic valve
- ultrasound guided
- quantum dots
- transcatheter aortic valve replacement