Cardiac Resynchronization Therapy: What Device Data Do We Need for Optimal Patient Treatment?

Abstract

The long experience of rate-responsive (RR) pacing and the technological advances in implantable devices form the basis for significant improvement of diagnostics for the treatment of atrial fibrillation (AF) or heart failure (HF) or both. In the past, the development of sensors for RR pacing gave the chance to investigate not only the effectiveness of physiological and mechanical sensors, but also long-term reliability and stability. Many sensors failed to demonstrate their long-term reliability and stability after implantation. For example, pressure sensors implanted in the right ventricle (RV) were totally surrounded by fibrosis after some months, making their membrane unreliable in detecting the true pressure. Similar problems were reported for oxygen saturation and pH sensors. Recently, pressure sensors for the RV have been proposed again for continuous monitoring of the hemodynamics of patients with HF: probably improvements in their technology have increased their long-term reliability. The strong competition for RR pacing in clinical practice has left in the market only the stable and reliable ones.