CRT Features Flashcards
Are ERI or Longevities different between Litronik / Greenbach
ERI voltage differs. LITRONIK = 2.85 // GB = 2.5
Longevity is the same
Biotronik is the only company to offer LV sensing. List 3 benefits and 1 thing it doesn’t do
LV channel = Markers / LV T-wave protect / Event Stat
LV sensing is not used for VF or Timing
Whats the max sensitivity on the LV
0.8mv
What is more likely to induce phrenic - Voltage or Pulse Width
Voltage - Lower Voltage and increase PW to compensate
What is the Maximum RV sensed Trigger Rate?
Upper Track rate + 20 // 160bpm // lowest VT zone
What is the minimum RV sensed trigger rate?
90bpm
How does LV T-wave protection work?
Resets the max trigger rate off the PVC - thus delays trigger pacing till after the T-wave
Why would you turn off ATM and ACC prior to implant?
Phrenic when testing post implant
How often does capture control measure?
1x 24hrs
Can capture control work at any pulse width?
No - only 0.4ms
What is Atrial Upper Rate?
NCAP - stops competitive pacing in the A, which lowers AF risk, which lowers HF risk
How does Atrial Upper Rate work?
When a PAC occurs in the PVARP a normal 300ms timer starts and doesn’t allow an A-pace
Essential PVC count is tantamount for effective HF monitoring - why?
Increase in PVCs shows:
Decompensating HF
Impending Shock
How does Vector opt work
RV Pace to LV1 / LV2 / LV3 / LV4
This is a surrogate for QLV
Relative service time is in the EDORA only - True/False
TRUE
AV opt has 4 stages - list them
1 - Determine P start on near field
2- Determine P end on Farfield (RA ring - RV ring)
3 - Measure
4 - + 50ms
Is AV opt dynamic?
No - must be done in house on a programmer
What percent of CRT patients are non responders?
30-40%
Ischemic patients do well from multisite pacing - True/false
TRUE
During multipole can you pace LV1 - RV - LV2?
NO - The LV 1 and 2 must follow each other
How many pacing configurations are there with multipole?
12
Amplitude and PW are independently programmable for each channel for Multipole - TRUE/FALSE
True - Biotronik exclusive
What does Rivacor have over Ilivia with regards to multipole pacing autocapture
Rivacor can auto capture both LV1 and LV2
Can you MPP with LV only pacing?
No - Must be BiV
Which is better - Max anatomical separation or electrical delay?
Anatomic separation
What can CRT auto adapt do?
Uses true RV and LV sensing to automatically adjust AV delay and set Vpacing to BiV or LV only
In non responders - what percentage is found to be AV delay inaccuracies?
30-40%
For CRT auto adapt to work, what 3 conditions must be met
Sinus Rhythm
Atrial rate <100bpm
A-RV conduction after pace <250ms
CRT auto adapt uses Auto AV conduction test as first step - how often does it do it?
Every minute - if fails it doubles the time like VP suppression - up to 17hrs
CRT auto adapt uses Auto AV conduction test as first step - what reduction in CRT does this take
1.4% per day
Auto AV looks at AV conduction times to RV and then LV. List the 3 possible outcomes and what they mean
A-RV < A-LV = LBBB
A-RV = A-LV = No BBB
A-RV > A-LV = RBBB
A-RV < A-LV = LBBB. What will be programmed?
Pacing = LV only
AV delay = Adapted AV (Either 70% of A-RV // A-RV - 40ms (whichever is shortest))
A-RV = A-LV = No BBB. What is programmed?
Pacing = BiV
AV delay = Adapted AV (Either 70% of A-RV // A-RV - 40ms (whichever is shortest))
A-RV > A-LV = RBBB. What is programmed?
Pacing = BiV
AV delay = Programmed values
CRT auto adapt must use same sensing and pacing cathodes. TRUE/FALSE
TRUE
LV only pacing in CRT auto adapt can only work if what is on?
LV capture control
Otherwise it will just perform AV adjustments as opposed to choosing BiV and LV only
What can’t CRT Autoadapt be programmed with
CLS and VDD (Dx)
Which CRT generations could take a DX lead
Ilivia onwards
In Dx if V>A what happens to SMART
Switched off - Goes back to onset / stability
