By S. Serge Barold, Philippe Ritter
The therapy of congestive center failure by way of implanted biventricular pacemakers, or cardiac resynchronization, has revolutionized the perform of implanting pacemakers and defibrillators. extra cardiac resynchronization remedy units than traditional pacemakers at the moment are being implanted and the numbers are turning out to be world wide. The e-book may be worthy to cardiologists, cardiac electrophysiologists, cardiac surgeons, cardiology fellows in education, extensive care experts and an individual drawn to pacing.
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Extra resources for Devices for Cardiac Resynchronization: Technologic and Clinical Aspects
L. Wilkoff contact with the myocardium, and the lead is actively fixated. Limitations with this approach include difficultly in positioning the device for lead delivery over the posterolateral left ventricle, inability to maneuver the device through diseased or postoperative pericardium, and finally, the possibility of pericardial inflammation from the epicardial lead. Conclusion Various techniques are described to facilitate pacing of the left ventricle to allow for resynchronization in heart failure.
Yu CM, Chau E, Sanderson JE, et al. Tissue Doppler echocardiographic evidence of reverse remodelling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure. Circulation 2002;105:438–45. 33 4 Alternative Means of Achieving Cardiac Resynchronization Michael O. Sweeney Importance of Achieving an Optimal Stimulation Site for Cardiac Resynchronization Therapy The optimal site for left ventricular (LV) pacing is an unsettled and complex consideration.
Phrenic stimulation can occur with surgically placed epicardial leads if careful visualization of the course of the nerve sheath is not performed prior to fixation. Chronic development of phrenic nerve stimulation results in permanent loss of CRT in about 1–2% of patients . Loss of CRT Due to Differential LV Capture Threshold Rise There is relatively limited data on long-term pacing thresholds with transvenous or thoracotomy leads for LV pacing. Loss of ventricular capture occurred in 10% of patients in the VENTAK CHF/CONTAK CD study and was the second most common cause of interrupted CRT .