Heart Failure Physicians Should Stop Looking at Pacing as a “Blackbox” and Learn Its Intrincacies Instead
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Presented at Hyde Park Session, HFSA meeting September 2017
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Heart Failure Physicians Should Stop Looking at Pacing as a “Blackbox” and Learn Its Intrincacies Instead
- 1. Heart Failure Physicians Should Stop Looking at Pacing as a “Blackbox” and Learn Its Intrincacies Instead Sergio L. Pinski, MD, FHRS Cleveland Clinic Florida Weston, FL, USA @SergioPinski #HFSA2017
- 2. Kroon et al. Heart Rhythm@SergioPinski #HFSA2017
- 3. Bunting et al. PACE 2017;40:35@SergioPinski #HFSA2017
- 6. RV apex RVOT RV sep NS-HBP S-HBP BI V BI V fusion Bi V ant @SergioPinski #HFSA2017
- 9. “Lack of response” to CRT • Poor selection: no dyssynchrony. Look at baseline ECG, no LBBB • Lack of resynchronization • Poor lead position: CXR, local activation • Lack of capture: high threshold, lead dislodgment, ECG, X-ray, testing • Suboptimal programming, AV, VV interval ECG, testing, ?echo • Abnormal rhythms inhibiting pacing: atrial fibrillation, ventricular ectopy, ECG @SergioPinski #HFSA2017
- 18. Anterior vein Posterolateral vein @SergioPinski #HFSA2017
- 23. Deprescribing! Why so difficult? @SergioPinski #HFSA2017
- 24. Martin et al. J Cardiovasc Electrophysiol 2012;23:1317@SergioPinski #HFSA2017
- 26. Boehmer et al. JACC Heart Failure 2017;5:216@SergioPinski #HFSA2017
- 28. Lustgarten et al. Heart Rhythm 2015;12:1548
- 30. Why you should manage pacing in your HF patients • It is not that difficult • It is fun • It is efficient & convenient for the patient • It is fiscally responsible from societal point of view. (It will also increase your RVUs if you care about that.) • Demand education & support from device companies • Patients should be referred to the EP only for suspected hardware problems or arrhythmias requiring treatment • You already do this with your LVAD patients @SergioPinski #HFSA2017
- 31. • The slides of this presentation will be available for download at slideshare.net/sergiopinski • Send comments via Twitter #HFSA2017 @SergioPinski