Left ventricular sensing by cardiac resynchronization devices

Left ventricular electrical delay can differentiate between ventricular and supraventricular tachycardia in cardiac resynchronization devices

“…LV sensing has gained interest in the recent years as CRT-Ds from several manufacturer's including Biotronik (Biotronik SE & Co. KG, Berlin, Germany) can store IEGMs from all three channels during tachycardias demonstrating dissimilarities between RV and LV rhythms ins some cases 5 . In addition, LV sensing can complicate biventricular pacing because the device has to negotiate three different timing cycles that can lead to unwanted suppression of biventricular pacing 6 .…”

Left ventricular inhibition during cardiac resynchronization caused by sensed left‐sided ventricular premature complexes

“…BIOTRONIK and Boston Scientific devices used for CRT can sense from the LV lead . LV sensing was designed primarily to prevent competitive pacing outside the LV myocardial absolute refractory period and it works by inhibiting the release of an LV stimulus in the vulnerable period of the LV myocardium.…”

“…LV sensing in Boston Scientific and BIOTRONIK CRT devices do not influence traditional DDD RV timing cycles. The special LV sensing function is based on limitation of the LV pacing rate by means of the LVURI . The LV Protection Period of Boston Scientific devices (LVPP) is equivalent to the LVURI .…”

“…BIOTRONIK and Boston Scientific devices used for CRT can sense from the LV lead. 2,4 LV sensing was designed primarily to prevent F I G U R E 4 Case 3: Same patient as in Figure 3. The recording shows false signals generated by a defective LV lead recorded a few days after Sensed isolated left-sided VPCs are not rare so that their coupling intervals are either inconsequential or they may affect device function in other ways.…”

“…Larsen et al 1 recently documented left ventricular (LV) inhibition of a normally functioning Boston Scientific device (Natick, MA, USA) for cardiac resynchronization therapy (CRT) caused by a mechanism unrelated to previously reported forms of LV paced event (LVp) inhibition from a variety of better known sources. 2 In their case, the LV output was suppressed by a critically timed single ventricular premature complex (VPC) that was sensed only by the LV channel. We report observations in two patients showing that the same device response can occur with BIOTRONIK CRT devices (Berlin, Germany) also designed with LV sensing.…”