Document Detail

Programmable multiple pacing configurations help to overcome high left ventricular pacing thresholds and avoid phrenic nerve stimulation.
MedLine Citation:
PMID:  16403156     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: High left ventricular pacing (LVP) thresholds and phrenic nerve stimulation (PNS) are common problems with cardiac resynchronization (CRT). Newer systems capable of multiple LVP configurations may help overcome these problems without the need for reoperation. METHODS: CRT systems capable of multiple LVP configurations (Guidant models H155 and H145) were implanted in 43 patients (study group). An additional 49 patients (control group) received CRT systems (Guidant, Medtronic, Biotronik, St. Jude Medical, various models) lacking this feature. RESULTS: Overall, acute high (> or =2.5 V/0.5 ms) LVP thresholds were encountered in 13 (30%) of the study group, and 25 (50%) of control group patients (P = 0.03). PNS was encountered in 5 (12%) of the study group and 12 (24%) of control group patients (P = 0.13). All cases of high LVP thresholds and PNS in the study group were managed by switching to a different LVP configuration, while high thresholds remained in control group patients, and PNS was managed by replacing the lead. The CS lead was successfully placed in a lateral branch in 95% of study group, compared to only 77% of control group patients (P = 0.004). CONCLUSIONS: Multiple LVP configurations were clinically useful in a significant number of patients undergoing CRT system implantation by helping to overcome high LVP thresholds and PNS, and by providing more flexibility in placing the LV lead.
Osnat Gurevitz; Eyal Nof; Shemy Carasso; David Luria; David Bar-Lev; Nechemya Tanami; Michael Eldar; Michael Glikson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  28     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-11     Completed Date:  2006-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1255-9     Citation Subset:  IM    
Heart Institute, Sheba Medical Center, Tel-Hashomer, Israel, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Chi-Square Distribution
Heart Conduction System / physiopathology*
Phrenic Nerve / physiology
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome
Ventricular Dysfunction, Left / physiopathology*,  therapy*

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