Left ventricle pacing challenges in cardiac resynchronization therapy systems
Left ventricle (LV) pacing can be considered peculiar due to its different lead/tissue interface (epicardial pacing) and the small vein wedging lead locations with less reliable lead stability. The current technologies available for LV capture automatic confirmation adopt the evoked response (ER), a...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-07-01
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| Series: | Indian Pacing and Electrophysiology Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629221000553 |
| _version_ | 1819144100343971840 |
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| author | Franco Zoppo Giulia Gagno |
| author_facet | Franco Zoppo Giulia Gagno |
| author_sort | Franco Zoppo |
| collection | DOAJ |
| description | Left ventricle (LV) pacing can be considered peculiar due to its different lead/tissue interface (epicardial pacing) and the small vein wedging lead locations with less reliable lead stability. The current technologies available for LV capture automatic confirmation adopt the evoked response (ER), as well as “LV pace to right ventricular (RV) sense” algorithms. The occurrence of anodal RV capture is today completely solved by the use of bipolar LV leads, while intriguing data are recently published regarding the unintentional LV anodal capture beside the cathodal one, which may enlarge the front wave of cardiac resynchronization therapy (CRT) delivery. The LV threshold behavior over time leading to ineffective CRT issues (subthreshold stimulation or concealed loss of capture), the extracardiac capture with phrenic nerve stimulation (PNS), the flexible electronic cathode reprogramming and the inadequate CRT delivery related to inadequate AV and VV pace timing (and its management by LV “dromotropic pace-conditioning”) are discussed.Moreover, recently, His bundle pacing (HBP) and left bundle branch pacing (LBBP) have shown growing interest to prevent pacing-induced cardiomyopathy as well as for direct intentional CRT.The purpose of the present review is to explore these new challenges regarding LV pacing starting from old concepts. |
| first_indexed | 2024-12-22T12:36:46Z |
| format | Article |
| id | doaj.art-c6ef7e8fd6334a62ac67ce6b11b78f41 |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-22T12:36:46Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-c6ef7e8fd6334a62ac67ce6b11b78f412022-12-21T18:25:34ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922021-07-01214232240Left ventricle pacing challenges in cardiac resynchronization therapy systemsFranco Zoppo0Giulia Gagno1Elettrofisiologia, Unità di Cardiologia, Ospedale Civile Gorizia (Italy) Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Italy; Corresponding author. Unità Operativa di Cardiologia, Ospedale Civile di Gorizia, Via Fatebenefratelli 34, 34170, Gorizia, ItalyDipartimento di Cardiologia, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), ed Università degli Studi di Trieste, ItalyLeft ventricle (LV) pacing can be considered peculiar due to its different lead/tissue interface (epicardial pacing) and the small vein wedging lead locations with less reliable lead stability. The current technologies available for LV capture automatic confirmation adopt the evoked response (ER), as well as “LV pace to right ventricular (RV) sense” algorithms. The occurrence of anodal RV capture is today completely solved by the use of bipolar LV leads, while intriguing data are recently published regarding the unintentional LV anodal capture beside the cathodal one, which may enlarge the front wave of cardiac resynchronization therapy (CRT) delivery. The LV threshold behavior over time leading to ineffective CRT issues (subthreshold stimulation or concealed loss of capture), the extracardiac capture with phrenic nerve stimulation (PNS), the flexible electronic cathode reprogramming and the inadequate CRT delivery related to inadequate AV and VV pace timing (and its management by LV “dromotropic pace-conditioning”) are discussed.Moreover, recently, His bundle pacing (HBP) and left bundle branch pacing (LBBP) have shown growing interest to prevent pacing-induced cardiomyopathy as well as for direct intentional CRT.The purpose of the present review is to explore these new challenges regarding LV pacing starting from old concepts.http://www.sciencedirect.com/science/article/pii/S0972629221000553Left Ventricle Pacing Challenges |
| spellingShingle | Franco Zoppo Giulia Gagno Left ventricle pacing challenges in cardiac resynchronization therapy systems Indian Pacing and Electrophysiology Journal Left Ventricle Pacing Challenges |
| title | Left ventricle pacing challenges in cardiac resynchronization therapy systems |
| title_full | Left ventricle pacing challenges in cardiac resynchronization therapy systems |
| title_fullStr | Left ventricle pacing challenges in cardiac resynchronization therapy systems |
| title_full_unstemmed | Left ventricle pacing challenges in cardiac resynchronization therapy systems |
| title_short | Left ventricle pacing challenges in cardiac resynchronization therapy systems |
| title_sort | left ventricle pacing challenges in cardiac resynchronization therapy systems |
| topic | Left Ventricle Pacing Challenges |
| url | http://www.sciencedirect.com/science/article/pii/S0972629221000553 |
| work_keys_str_mv | AT francozoppo leftventriclepacingchallengesincardiacresynchronizationtherapysystems AT giuliagagno leftventriclepacingchallengesincardiacresynchronizationtherapysystems |