Optimization of Cardiac Resynchronization Therapy
- Task Force® Monitor
In 20%-30% of congestive heart failure patients an additional dysfunction of the intraventricular spread of stimulus is observable (broad QRS-complex > 150 ms). This asynchronisation leads to an impairment of systolic function.
Goal of the cardiac resynchronization therapy (CRT) is the stabilisation of the contraction due to a synchronization of the right and left ventricular excitation. The optimization of the stimulation interval between atrium and ventricle – AV-delay – also improves diastolic function of the heart and increases cardiac function up to 5%-10% in patients with CRT-pacemakers and thus improves patients’ lives.
The Task Force® Monitor provides non-invasively and online each hemodynamic change depending on different pacemaker settings. This leads to a
- simple,
- fast and
- very cost effective
way to optimize pacemaker settings.
"In conclusion, the present study confirms TEIC as a promising alternative with reliable results for AV-interval optimization. Due to its noninvasive character, low costs, the continuous beat-to-beat analysis and its good correlation to Doppler echocardiography measurements TEIC represents a favourable technique for AV-interval optimization during routine follow-up in CRT patients. However, according to great interindividual variations in the optimal AV-interval, it is essential to determine the best AV-interval for each patient individually."
Continuous fine-tunig protocol for optimal settings
The TFM can be easily used together with a programming device to find the optimized pacemaker settings - a procedure that can be done very fast as the measurement system stays applied to the patient all the time and does not need any recalibration. One cycle is just a matter of a few minutes....
Trend view
The impact of different settings is visible in the trend view
The Task Force® Monitor records blood pressure, stroke volume and the ECG truly continuously and therefore shows the impact of each individual setting. Additionally, manually set intervention markers document when the pacemaker was activated or deactivated.
Impedance curve
The impedance curve indicates the quality of settings
In the example below, the immediate change to the impedance curve as the pacemaker is switched off can be watched. The amplitude of the impedance curve can be interpreted as indicator for the volume of blood pumped at a heart beat. Corresponding to that, the amplitude of the pressure curve also decreases.
