Programming and Follow-up of Cardiac Resynchronization Therapy Devices: Troubleshooting

Abstract

Cardiac resynchronization therapy is a well-recognized treatment option in patients with advanced heart failure, left ventricular dysfunction and dyssynchrony. This mode of therapy improves symptoms, quality of life, and mortality. The devices used are designed to specifically pace the left ventricle, and for this reason they have a number of unique programming issues that will be discussed in the present chapter. The complexity of CRT devices and the need for careful management of severe heart failure patients emphasize the need for a multidisciplinary team. The efficacy of CRT is based on monitoring the function of the devices by means of assessment of the clinical status of the patient, electrocardiographic follow-up and interrogation of the device. The present chapter offers an in-depth review of the different electrocardiographic patterns than can be obtained in CRT patients.

Keywords: Heart failure, cardiac resynchronization therapy, surface electrocardiogram, left ventricular pacing, anodal capture, programming, follow-up, cardiac resynchronization therapy devices, troubleshooting