CRT Implantation and Optimization
Cardiac Resynchronization Therapy (CRT) is being used more and more as a therapy method for HF problems rather than therapy of arrhythmia problems as is done by AV pacemakers.
Currently, the use of CRT suffers from 2 major problems:
- High rate (30%) of non responsive patient for CRT implantation.
- Lacking of a simple and easy to use method for CRT optimization results in compromised Cardiac Output improvement and reduced rate of success in solving HF problems.
Bioimpedance cardiograph can provide a good solution for CRT optimization (1).
NICaS is a superior device for this application in comparison to other bioimpedance devices due to its high accuracy as well as reproducibility and its wrist – ankle sensors configuration that keep the thorax area free of sensors.
As a result, the NICaS can solve these 2 major problems.
High rate of non responders
Non responders are in many cases the results of a compromised location of the electrodes in the right atrium, and both ventricles. NICaS can provide left ventricular contraction feedback during the implantation, resulting in the ability to locate the electrodes at more responsive locations and reducing rate of non responders.
By obtaining a continuous Cardiac Output reading by using the NICaS, AV and VV delays can be set so that Cardiac Output can be maximized. See Figure 1 for NICaS Comparative Screen during CRT optimization.
- Konstantin M. Heinroth at el: Impedance Cardiography: a useful and reliable tool in optimization of CRT; Europace 2007 9,744-750
- Serge Barold at el: Echocardiographic optimization of the atrioventricular and interventricular intervals during cardiac resynchronization; Europace 2008 10,88-95
- Robert G. Turcott et al, Measurement Precision in the Optimization of Cardiac Resynchronization Therapy, Circulation Heart Failure 2010;3:395-404, February 22, 2010