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Cardiac resynchronisation therapy (CRT or CRT-P) is the insertion of electrodes in the left and right ventricles of the heart, as well as on occasion the right atrium, to treat heart failure by coordinating the function of the left and right ventricles via a pacemaker, a small device inserted into the anterior chest wall.
The FDA approved the OPTIMIZER Smart System, which delivers cardiac contractility modulation therapy, as indicated to improve 6-minute hall walk distance, quality of life, and functional status of NYHA Class III heart failure patients who remain symptomatic despite guideline directed medical therapy, who are in normal sinus rhythm, are not indicated for cardiac resynchronization therapy, and ...
Percussive pacing, also known as transthoracic mechanical pacing, is the use of the closed fist, usually on the left lower edge of the sternum over the right ventricle in the vena cava, striking from a distance of 20 – 30 cm to induce a ventricular beat (the British Journal of Anaesthesia suggests this must be done to raise the ventricular pressure to 10–15 mmHg to induce electrical activity).
[18] [20] Since its first discovery, there have been many definitions of pacemaker syndrome, and the understanding of the cause of pacemaker syndrome is still under investigation. In a general sense, pacemaker syndrome can be defined as the symptoms associated with right ventricular pacing relieved with the return of A-V and V-V synchrony. [17]
Crosstalk can only occur in a dual chamber or biventricular pacemaker. It happens less often in more recent models of dual chamber pacemakers due to the addition of a ventricular blanking period, which coincides with the atrial stimulus. This helps to prevent ventricular channel oversensing of atrial output.
HCN4 is the main isoform expressed in the sinoatrial node, but low levels of HCN1 and HCN2 have also been reported.The current through HCN channels, called the pacemaker current (I f), plays a key role in the generation and modulation of cardiac rhythmicity, [13] as they are responsible for the spontaneous depolarization in pacemaker action potentials in the heart.
A normal chest X-ray after placement of an ICD, showing the ICD generator in the upper left chest and the ICD lead in the right ventricle of the heart. Note the 2 opaque coils along the ICD lead. The process of implantation of an ICD system is similar to implantation of an artificial pacemaker. In fact, ICDs are composed of an ICD generator and ...
Dilated coronary sinus is also seen in some congenital cardiovascular conditions, such as persistent left superior vena cava, [8] and total anomalous pulmonary venous return. [9] In Cardiac Resynchronization Therapy (CRT) procedures, a critical step involves the insertion of a pacing lead into the coronary vein system. However, the anatomical ...