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Flashcards in CRT Algorithms Deck (34)
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1

 

Three Types of 

Pacing in CRT

2

 

AdaptivCRT 

Step 1

Accessing Intrinsic Conduction

3


AdaptivCRT

LV Pacing v RV 

4

 

AdaptivCRT

3 Step Algorithm

The Adaptive Bi-V and LV setting can be summarized as a three step algorithm:

Step 1: The device assesses intrinsic conduction to determine if a patient's AV interval is normal or prolonged.


Step 2: The device determines the pacing method to be either Adaptive LV or Adaptive Bi-V.


Step 3: The device optimizes the timing of the AV and V-V delays, and pacing configuration.

5

 

AdaptivCRT

LV Pacing 

Summary

 

6

 

AdaptivCRT

Switching from BiV to LV

7

 

AdaptivCRT

When does LV Pacing v

 BiV Pacing

8

 

AdaptivCRT

Step 2 Determining

Pacing Method

 

9

AdaptivCRT

AV Interval 

Measurement Test

 

10

 

AdaptivCRT

Algorithm

Description

 

11

 

AdaptivCRT

AV Interval Measurement

Test

12

 

Optivol

Impedance and

Optivol Relationship

 

13

 

Optivol Summary

 

Intrathoracic impedance measurements are made at 20-minute intervals between 12:00 pm and 5:00 pm using the RV Coil to Can pathway (RV pace sense tip to Can in Consulta™ CRT-P), which passes through the tissue within the thoracic cavity. After all of the impedance measurements for a day have been made, the average impedance value is calculated for that day. The thoracic impedance graph, which is the lower graph, plots the average daily impedance value trend data. This daily impedance value is used to update a slowly adapting trend known as the reference impedance, which is calculated by the device. In this way, a control value for each individual patient is calculated. The device uses this control value to assess impedance variations. 
 
If the daily impedance falls below the reference impedance, this may indicate that fluid is accumulating in the patient’s thoracic cavity. If the daily impedance remains below the reference impedance, the difference between the daily impedance and reference impedance values, adjusted for individual patient variation, is added to the OptiVol fluid index. While there is a difference between the daily impedance and the reference impedance, the fluid index may continue to increase. If the daily impedance begins to rise, this may be an indication that the thoracic fluid accumulation is resolving and the fluid index may decrease. When the daily impedance returns to the reference impedance, the fluid event is considered to have ended and the OptiVol fluid index resets to 0.

14

 

 

Optivol Graphs

Fluid Index v 

Impedance Measurements

15

 

OptiVol

Graph Interpretation

16

 

OptiVol

Factors affecting

Impedance

17

 

Optivol 

Sensitivity

18

 

 

Optivol Study

Sensitivity 

19

 

OptiVol 

Programming

20

 

OptiVol

Dietary Nonadherence

Patient

21

 

Optivol 

Stable Patient

22

 

OptiVol

Meds Nonadherence

23

 

Atrial Tracking 

Recovery

24

 

Ventricular Sense

Response 

25

 

When does

Adaptiv Bi-V Occur

 

26

 

Optivol 

Interpretation 

Process

27

 

OptiVol

Measurement Times

28

 

OptiVol

Events that affect Impedance

 

29

 

OptiVol

Interpreting

Fluid Index

30

 

AdaptivCRT

How it works