Timing cycles
5 important questions on Timing cycles
Op welke leads kan er gesensed worden bij een CRT-P of een CRT-D
BSX: Rv + LV sense maar alleen RV wordt gebruikt voor sensing en detectie. LV is puur voor counters en histogram
MDT: RV of LV sense unipolair of bipolair in CRT-D alleen Bip.
Sorin: Alleen EGM input van LV lead
SJM: RV alleen sense, om metingen te doen kan er wel LV gesensed worden
Wat voor feature bij de CRT-P en de CRT-D helpt mee aan optimale biv pacing
Sommige fabrikanten verlengen toch soms even het AV delay. Als er een VP volgt dan blijft dat AV delay zo staan ivm optimale diastolische vulling. Als er een Vs plaatsvindt dan wordt het AV delay weer korter gemaakt.
VSR ventricular sense response zorgt ervoor dat er bij een RVs een LVP getriggerd wordt , dit kan ook met een DDT mode.
Ook de hoge drempel in LV kan CRT pacing negatief beïnvloeden. Vaak zit er een automatische drempel meting in de CRT's om dit te voorkomen.
Wat voor feature voorkomt LV pacing gedurende de vulnerabele periode van de LV
De Pm zal de output inhiberen omdat er anders ritmestoornissen kunnen ontstaan.
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ECG bij geen apicale RV pacing
V1 is negatief
II,III en AVF zijn positief
Bij septale pacing:
Smal QRS complex, dit komt door het simultane contractie van LV en RV.
Vrije wand:
Breed QRS complex
Grote R wave in Lead I
ECG bij Links laterale vrije wand pacing
V1 -> positief(RBT)
Lead I is meestal negatief
Afleiding V4, V5 en V6 en AVR hebben meestal dezelfde vector met mid vrije wand pacing, omdat de activatie zowel door de apex als door het basale deel van het hart gaat(AVR)
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