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CPP Follow-up and Management
Follow-up evaluations
COR LOE Recommendations
1 B-NR
(CRT)
1. After implantation of a CPP device in patients with heart
failure with reduced ejection fraction (HFrEF), a follow-up
echocardiogram within 3–12 months is useful to determine
reverse remodeling and the likelihood of improved survival
and reduction in HFH.
C-EO
(HBP,
LBBAP)
1 B-NR 2. In patients with CPP, remote monitoring is beneficial for
device and arrhythmia management.
2a B-NR
(CRT)
3. In patients with CPP and HF, multidisciplinary management
with HF and device clinics for adjustment of medications
and device programming can be useful to improve clinical
outcomes.
C-EO
(HBP,
LBBAP)
2a C-LD 4. In patients with CRT and HFimpEF, continuation of
GDMT is reasonable to reduce the risk of HF relapse and
arrhythmias and treat hypertension.
3: No
Benefit
B-R 5. In patients with CRT and HFrEF, routine use of thoracic
impedance alone to manage congestive HF is not
recommended.
Optimization of CPP response
COR LOE Recommendations
1 C-EO 1. In patients with CRT, a 12-lead ECG is useful to confirm
LV lead capture and facilitate optimization of LV pacing
configurations.
1 B-NR 2. During in-office follow-up of patients with CSP, a multi-lead
or 12-lead ECG is recommended to assess conduction system
capture, including BBB correction.
2a B-NR 3. During in-office follow-up of patients with CSP, a
comprehensive assessment that includes documentation of
His/left bundle capture, BBB correction, and myocardial
capture thresholds can be useful.
2a C-EO 4. In patients with HBP who have an increase in threshold of
>1 V, more frequent in-office follow-up can be beneficial to
determine the need for lead revision, especially in ventricular
pacing-dependent patients.
