Cardiocases casebook

Boston Scientific CRT — clinical cases

M. Strik. The cases of the Boston Scientific CRT teaching day, in five chapters; every numbered marker on an electrogram is one tap from its explanation, on a phone or a desktop.

1LV pacing and threshold

1Reading a full LATITUDE CRT-D follow-up report2Ambulatory PaceSafe LV threshold test3PaceSafe LV test with an unexpected beat4Non-responder despite 100% BiV pacing5Remote real-time EGM in a dialysis patient6LV impedance alert and an odd PaceSafe LV test7BiV Trigger in AF, and the same patient 15 months later8CRT-D with a conduction-system lead: the LV trends jump

2LV impedance

1LV pacing impedance climbing after implant2LV impedance out-of-range alert near battery end of life3LV impedance jump after an office visit4LV threshold and impedance rising in the first weeks after implant

3Sensing

1Extra LV sensed events in a CRT-D programmed VVI 402Intermittent RV-only paced beats in a RESONATE CRT-D3LV-only pacing with oversensing on the LV and on the RV channel4Intermittent loss of LV pacing despite 99% RV pacing5CRT-D shock: and what about the LV channel?

4Keeping up the CRT

1CRT-P in AF: two different pacing percentages2CRT-D in sinus rhythm, BiV pacing 89%3CRT pacing alert at 57%, and 2 years later4RV paced 100%, LV only 86%5CRT drop in a patient with atrial ectopy6A stored PMT episode at 130 min-17Exercise: sinus tachycardia in the VT-1 zone8Exercise, anti-PMT algorithm and long PR9Exercise, anti-PMT algorithm and LV sensing10Sinus tachycardia, Wenckebach and pro-arrhythmia11Ventricular episodes in a CRT-P: what started them?12RA lead impedance alert in a paced CRT patient13BiV markers with changing far-field morphology14CRT drop and low-amplitude atrial events15CRT loss at rest with sinus bradycardia

5Bonus

1CRT with a dual chamber pacemaker using LBBAP2Tachycardia while dancing: what the CRT-P and the S-ICD saw3LOT-CRT with a Boston CRT-P

From Boston Scientific CRT — clinical cases by M. Strik. Published by Cardiocases. Every numbered marker on a recording is explained in the list beneath it; tap a marker on the trace or an entry in the list.