CRT Features

Question 1

Are ERI or Longevities different between Litronik / Greenbach

Answer 1

ERI voltage differs. LITRONIK = 2.85 // GB = 2.5

Longevity is the same

Question 2

Biotronik is the only company to offer LV sensing. List 3 benefits and 1 thing it doesn’t do

Answer 2

LV channel = Markers / LV T-wave protect / Event Stat

LV sensing is not used for VF or Timing

Question 3

Whats the max sensitivity on the LV

Answer 3

0.8mv

Question 4

What is more likely to induce phrenic - Voltage or Pulse Width

Answer 4

Voltage - Lower Voltage and increase PW to compensate

Question 5

What is the Maximum RV sensed Trigger Rate?

Answer 5

Upper Track rate + 20 // 160bpm // lowest VT zone

Question 6

What is the minimum RV sensed trigger rate?

Answer 6

90bpm

Question 7

How does LV T-wave protection work?

Answer 7

Resets the max trigger rate off the PVC - thus delays trigger pacing till after the T-wave

Question 8

Why would you turn off ATM and ACC prior to implant?

Answer 8

Phrenic when testing post implant

Question 9

How often does capture control measure?

Answer 9

1x 24hrs

Question 10

Can capture control work at any pulse width?

Answer 10

No - only 0.4ms

Question 11

What is Atrial Upper Rate?

Answer 11

NCAP - stops competitive pacing in the A, which lowers AF risk, which lowers HF risk

Question 12

How does Atrial Upper Rate work?

Answer 12

When a PAC occurs in the PVARP a normal 300ms timer starts and doesn’t allow an A-pace

Question 13

Essential PVC count is tantamount for effective HF monitoring - why?

Answer 13

Increase in PVCs shows:

Decompensating HF
Impending Shock

Question 14

How does Vector opt work

Answer 14

RV Pace to LV1 / LV2 / LV3 / LV4

This is a surrogate for QLV

Question 15

Relative service time is in the EDORA only - True/False

Answer 15

TRUE

Question 16

AV opt has 4 stages - list them

Answer 16

1 - Determine P start on near field
2- Determine P end on Farfield (RA ring - RV ring)
3 - Measure
4 - + 50ms

Question 17

Is AV opt dynamic?

Answer 17

No - must be done in house on a programmer

Question 18

What percent of CRT patients are non responders?

Answer 18

30-40%

Question 19

Ischemic patients do well from multisite pacing - True/false

Answer 19

TRUE

Question 20

During multipole can you pace LV1 - RV - LV2?

Answer 20

NO - The LV 1 and 2 must follow each other

Question 21

How many pacing configurations are there with multipole?

Answer 21

12

Question 22

Amplitude and PW are independently programmable for each channel for Multipole - TRUE/FALSE

Answer 22

True - Biotronik exclusive

Question 23

What does Rivacor have over Ilivia with regards to multipole pacing autocapture

Answer 23

Rivacor can auto capture both LV1 and LV2

Question 24

Can you MPP with LV only pacing?

Answer 24

No - Must be BiV

Question 25

Which is better - Max anatomical separation or electrical delay?

Answer 25

Anatomic separation

Question 26

What can CRT auto adapt do?

Answer 26

Uses true RV and LV sensing to automatically adjust AV delay and set Vpacing to BiV or LV only

Question 27

In non responders - what percentage is found to be AV delay inaccuracies?

Answer 27

30-40%

Question 28

For CRT auto adapt to work, what 3 conditions must be met

Answer 28

Sinus Rhythm Atrial rate <100bpm A-RV conduction after pace <250ms

Question 29

CRT auto adapt uses Auto AV conduction test as first step - how often does it do it?

Answer 29

Every minute - if fails it doubles the time like VP suppression - up to 17hrs

Question 30

CRT auto adapt uses Auto AV conduction test as first step - what reduction in CRT does this take

Answer 30

1.4% per day

Question 31

Auto AV looks at AV conduction times to RV and then LV. List the 3 possible outcomes and what they mean

Answer 31

A-RV < A-LV = LBBB A-RV = A-LV = No BBB A-RV > A-LV = RBBB

Question 32

A-RV < A-LV = LBBB. What will be programmed?

Answer 32

Pacing = LV only | AV delay = Adapted AV (Either 70% of A-RV // A-RV - 40ms (whichever is shortest))

Question 33

A-RV = A-LV = No BBB. What is programmed?

Answer 33

Pacing = BiV | AV delay = Adapted AV (Either 70% of A-RV // A-RV - 40ms (whichever is shortest))

Question 34

A-RV > A-LV = RBBB. What is programmed?

Answer 34

Pacing = BiV | AV delay = Programmed values

Question 35

CRT auto adapt must use same sensing and pacing cathodes. TRUE/FALSE

Answer 35

TRUE

Question 36

LV only pacing in CRT auto adapt can only work if what is on?

Answer 36

LV capture control Otherwise it will just perform AV adjustments as opposed to choosing BiV and LV only

Question 37

What can't CRT Autoadapt be programmed with

Answer 37

CLS and VDD (Dx)

Question 38

Which CRT generations could take a DX lead

Answer 38

Ilivia onwards

Question 39

In Dx if V>A what happens to SMART

Answer 39

Switched off - Goes back to onset / stability