Patient
This 69-year-old man with dilated cardiomyopathy and left bundle branch block received a Biotronik triple chamber defibrillator. He initially responded to CRT, before his clinical degradation. He was followed by telemedicine.
Graph and trace
- This telemedicine tracing was transmitted in absence of anomaly detected by the device.
- Periodic EGM.
- BiV stimulation with probable capture.
- BiV stimulation with probable absence of LV capture. Sensing by the left lead of a depolarization initiated by the right-sided lead (LVs).
This tracing shows the value (transmission of periodic EGM ) and the difficulty of follow-ups by remote monitoring of CRT recipients. This patient presented with intermittent loss of LV capture because of flawed programming (safety margin too narrow). LV sensing facilitated the diagnosis, as the LV markers drew the attention of the technicians in charge of the telemedicine follow-up.