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Tools and techniques for CRT with BiV pacing
COR LOE Recommendations
1 B-R 1. In patients undergoing CRT implant, a quadripolar LV lead
is recommended to assist with lead stability, lower capture
thresholds, avoid phrenic nerve pacing, and decrease need for
lead repositioning.
2a B-NR 2. In patients undergoing CRT implant, lead positioning and
programming the device to deliver the narrowest QRS
duration can be beneficial in improving LV structure and
function.
2a C-LD 3. In patients undergoing CRT implant, LV lead placement to
allow for pacing from a nonapical position is reasonable to
improve CRT clinical and structural response.
2b C-LD 4. In patients undergoing CRT implant, targeting lead
placement at sites of late ventricular activation may be
considered to improve CRT response.
Tools and techniques for CSP
COR LOE Recommendations
1 C-EO 1. In patients undergoing CSP with HBP or LBBAP, 12-lead
ECG is useful during implantation to assess conduction
system capture most accurately.
1 C-EO 2. In patients undergoing CSP with HBP or LBBAP, accurate
demonstration of conduction system capture thresholds
(including bundle branch block [BBB] correction) and
myocardial capture thresholds at implant is useful for
appropriate programming of the device.
2a C-LD 3. In patients undergoing CSP with HBP or LBBAP, assessment
of His bundle/left bundle current of injury using appropriate
filter settings can be beneficial in achieving acceptable capture
thresholds and lead stability.
Implant Procedure
