A novel algorithm increases the delivery of effective cardiac resynchronization therapy during atrial fibrillation: The CRTee randomized crossover trial

Plummer, Chris; Frank, Christopher M.; Bári, Zsolt; Hebaishi, Yahya S. Al; Klepfer, Ruth Nicholson; Stadler, Robert; Ghosh, Subham; Li, Shufeng; Mittal, Suneet

doi:10.1016/j.hrthm.2017.10.026

Cited by 28 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the performance CAFR has not been fully evaluated in a clinical study with patient outcomes. Medtronic has also developed an algorithm called effective CRT during AF that attempts to maximize effective CRT by increasing pacing rate based on analysis of the paced morphology of the unipolar LV electrogram (to distinguish LV capture from pseudo fusion) . Other device companies have similar triggered algorithms to maximize biventricular pacing…”

Section: Discussionmentioning

confidence: 99%

Maximizing biventricular pacing in patients with rate‐controlled atrial fibrillation using ventricular sense response

Montemezzo

AlTurki

Essebag

2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

In patients with atrial fibrillation (AF), cardiac resynchronization therapy (CRT) is challenging because the ventricular rate of conducted AF exceeds the biventricular pacing rate. In the current report, we present a patient who received a CRT device that was programmed to ventricular sense response (VSR) on with VVI 40 beats per minute to allow the AF to be paced as fusion beats. We found that the pacing configuration resulting in the narrowest QRS in this patient was VVI 40 with VSR biventricular fusion pacing during AF. VSR mode allows for CRT delivery without the need to artificially increase heart rate. K E Y W O R D Satrial fibrillation, biventricular pacing, cardiac resynchronization therapy, ventricular sense response

show abstract

Section: Discussionmentioning

confidence: 99%

Maximizing biventricular pacing in patients with rate‐controlled atrial fibrillation using ventricular sense response

Montemezzo

AlTurki

Essebag

2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…Twenty patients assigned to pharmacological treatment and 10 assigned to ablation and pacing had a heart failure event (heart failure related death, hospitalisation or worsening) which was statistically significant; quality of life also improved in the ablate and pace group (115). New algorithms may help deliver bi-ventricular pacing more effectively in patients with atrial fibrillation (183). However, CRT is more than just bi-ventricular pacing.…”

Section: Devices and Transplantation (700 Words)mentioning

confidence: 99%

The year in cardiology 2018: heart failure

Cleland

Veldhuisen

Ponikowski

2019

European Heart Journal

View full text Add to dashboard Cite

“…It has been reported that in 50% of patients, a part of the measured biventricular pacing during programmed pacing is actually a fusion wave; this phenomenon is more obvious in patients with atrial fibrillation [44]. To solve this problem, a new algorithm has been developed; when the total capacity of fusion pacing exceeds a certain threshold, the pacemaker will automatically increase the pacing frequency appropriately [45]. Such a new algorithm for left ventricular fusion wave pacing may be useful in non-responders.…”

Section: Program Optimizationmentioning

confidence: 99%

Prevention of non-response to cardiac resynchronization therapy: points to remember

et al. 2019

View full text Add to dashboard Cite

Cardiac resynchronization therapy (CRT) is an important and effective therapy for end-stage heart failure. Non-response to CRT is one of the main obstacles to its application in clinical practice. There is no uniform consensus or definition of CRT "response." Clinical symptoms, ventricular remodeling indices, and cardiovascular events have been reported to be associated with nonresponders. To prevent non-response to CRT, three aspects should be thoroughly considered: preoperative patient selection, electrode implantation, and postoperative management. Preoperative selection of appropriate patients for CRT treatment is an important step in preventing non-response. Currently, the CRT inclusion criteria are mainly based on the morphology of QRS waves in deciding ventricular dyssynchrony. Echocardiography and cardiac magnetic resonance are being explored to predict nonresponse to CRT. The location of left ventricular electrode implantation is a current hot spot of research; it is important to identify the location of the latest exciting ventricular segment and avoid scars. Cardiac magnetic resonance and ultrasonic spot tracking are being progressively developed in this field. Some new techniques such as His Bundle pacing, endocardial electrodes, and novel sensors are also being investigated. Postoperative management of patients is another essential step towards preventing non-response; it mainly focuses on the treatment of the disease itself and CRT program control optimization. CRT treatment is just one part of the overall treatment of heart failure, and multidisciplinary efforts are needed to improve the overall outcome.

show abstract

A novel algorithm increases the delivery of effective cardiac resynchronization therapy during atrial fibrillation: The CRTee randomized crossover trial

Cited by 28 publications

References 14 publications

Maximizing biventricular pacing in patients with rate‐controlled atrial fibrillation using ventricular sense response

Maximizing biventricular pacing in patients with rate‐controlled atrial fibrillation using ventricular sense response

The year in cardiology 2018: heart failure

Prevention of non-response to cardiac resynchronization therapy: points to remember

Contact Info

Product

Resources

About