P.2. Syncope, Pacemaker, CRT & ICD: P.2.14 Unique BI-V Lead Setups for Closed-Loop Stimulation Rate Adaptation

Abstract

Objective

The physiologic Closed Loop Stimulation (CLS) sensor translates localized myocardial impedance via an RV endocardial lead into pacing rates. CLS rate adaptation using non-traditional Bi-V lead configurations is unknown and was investigated.

Methods

We examined acute (hall walk) and long-term rate adaptations over 7-14 months post implant in 5 CLS pacemaker patients with various non-traditional Bi-V configurations, positioning leads at RV apex and/or outflow tract, LV epicardium, or coronary sinus, with/without Y adaptors.

Results

Hall walks after CLS activation showed acute rate support in 4 of 4 patients tested. Patients were then CLS Bi-V paced for 6 to 8 months. Total atrial pacing varied 57-99% among 5 patients. CLS sensor-driven pacing occurred 22-95% of the time and spanned the full range between lower and maximum sensor rates for all patients.

Conclusion

CLS provides rate-adaptive pacing in response to patients' metabolic needs during chronic and acute situations using non-traditional lead configurations. CLS rate adaptation may contribute physiologic benefits to CHF pts undergoing CRT and warrants further investigation.