{"id":814,"date":"2025-07-31T14:24:09","date_gmt":"2025-07-31T14:24:09","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=814"},"modified":"2026-02-01T08:27:18","modified_gmt":"2026-02-01T08:27:18","slug":"left-ventricular-pacing-microport","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/","title":{"rendered":"Left ventricular pacing Microport"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"814\" class=\"elementor elementor-814\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-16f1299 e-con-full e-flex e-con e-parent\" data-id=\"16f1299\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4d92c29 elementor-widget elementor-widget-heading\" data-id=\"4d92c29\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Microport - Left ventricular pacing<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8f6633a elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"8f6633a\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h3&quot;,&quot;h4&quot;,&quot;h5&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;fas fa-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;,&quot;rendered_tag&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-circle\\&quot; viewBox=\\&quot;0 0 512 512\\&quot; xmlns=\\&quot;http:\\\/\\\/www.w3.org\\\/2000\\\/svg\\&quot;&gt;&lt;path d=\\&quot;M256 8C119 8 8 119 8 256s111 248 248 248 248-111 248-248S393 8 256 8z\\&quot;&gt;&lt;\\\/path&gt;&lt;\\\/svg&gt;&quot;},&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tContent\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__8f6633a\" aria-expanded=\"true\" aria-label=\"Ouvrir la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__8f6633a\" aria-expanded=\"true\" aria-label=\"Fermer la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__8f6633a\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ff3a5a4 elementor-widget elementor-widget-heading\" data-id=\"ff3a5a4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">General information<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3dc7c1d elementor-widget elementor-widget-text-editor\" data-id=\"3dc7c1d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"rtejustify\"><strong>Configuration of left ventricular stimulation<\/strong><\/p><p class=\"rtejustify\">The various programming options available enable the selection of a LV stimulation polarity associated with a reliable and durable myocardial capture with the least amount of power necessary in order to maximize the longevity of the device, without stimulating the phrenic nerve. The programming of the stimulation amplitude must optimize the battery life while preserving a sufficient safety margin. The LV epicardial stimulation threshold is often higher (twice as high in one study) and more variable than the RV stimulation threshold. It might not be possible to obtain a safety margin as high as twice the capture threshold since, when &gt;2.0 V, the batteries will likely be prematurely depleted. In some patients the stimulation amplitude and pulse width must be meticulously programmed to capture the left ventricle without phrenic nerve stimulation. The influence of the LV stimulation configuration on the quality of response to cardiac resynchronization remains to be determined and rarely represents a selection criterion.<\/p><p class=\"rtejustify\">The armamentarium offered by the various device manufacturers includes uni-, bi- and quadripolar LV leads. The stimulation polarity is programmable in the left ventricle by choosing a quadripolar (4 electrodes) or non-quadripolar (1 or 2 electrodes) lead. If a\u00a0<em>unipolar LV lead<\/em>\u00a0is implanted, a single configuration (LV tip to RV ring or RV coil) might be programmable depending on the manufacturer and type of device. With most defibrillators, the RV coil is used instead of the RV ring. With CRT-P, the RV ring (proximal electrode of a bipolar lead) is used. With some devices and, depending on the manufacturer, the pulse generator may participate in the pacing vector, offering the programming of LV tip \u00e0 pulse generator (can) as second choice of stimulation configuration. If a bipolar LV lead is implanted, between 3 and 6 configurations are available depending on the manufacturer and type of device. The threshold is often higher with LV ring to RV coil configuration and the distal LV electrode (cathode) is preferentially used as the active electrode, while the RV coil or LV ring (anode) are used as the indifferent electrode. If a quadripolar LV lead is implanted, between 12 and 17 configurations are available depending on the manufacturer and the type of device. This multitude of choices allows an optimization of the capture threshold and a lower likelihood of phrenic nerve stimulation. With a wide spacing of the electrodes, the activation sequence can be varied, for example by choosing a distal (apical) versus proximal (basal) electrode. This choice may have a positive impact on the response rate, despite the paucity of criteria objectively predictive of the quality of response to therapy. Now most CRT devices offer a choice of dual site LV stimulation, with the idea that an increase in the number of stimulated sites decreases the activation dyssynchrony even further. This also has never been proven in multi-center randomized clinical trials.<\/p><p class=\"rtejustify\"><strong>Anodal capture<\/strong><\/p><p class=\"rtejustify\">The pulse strength influences the likelihood of anodal capture. The cathode at the tip of the LV lead is usually smaller than the anode, explaining the high current density at that site. A strong pulse may create a high enough current density to capture the tissue near the anode. The RV ring of CRT-P is often used as anode to stimulate the left ventricle. A high-amplitude stimulation may cause an anodal RV capture resulting in triple-point\u00a0stimulation: LV and RV cathodes + RV anode. Anodal capture is more likely when the LV stimulation configuration includes a true RV bipolar lead (lead ring) instead of an integrated bipolar lead (since the anode is the distal coil), probably because the small size of the ring promotes a higher current density. The electrocardiographic morphology is often slightly modified compared with the usual BiV appearance. A 12-lead electrocardiogram, instead of the single channel of the programmer, is usually needed for the diagnosis. On the other hand, an anodal capture may considerably modify the analysis of the tracings during the LV threshold test. The hemodynamic effect of this type of stimulation, which increases the number of stimulated sites, might be positive, though the clinical results remain to be seen. An anodal capture usually requires strong stimulation pulses, which shorten the devices\u2019 life expectancy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-98752be elementor-widget elementor-widget-heading\" data-id=\"98752be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Testing the LV lead<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6e12e1e elementor-widget elementor-widget-text-editor\" data-id=\"6e12e1e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Testing an implanted lead comprises analysis of the impedance, threshold and sensing capabilities, comparing it with previously recorded values. This is no different for the LV lead lead in exception for sensing, as the LV lead is not used for sensing in MicroPort devices (only in Biotronik and Boston Scientific CRT devices).<\/p><p><strong>LV threshold test<\/strong><\/p><p>The test is very similar to the RV lead threshold test, it is launched in DOO mode with a starting output (3.5V in the example) which decreases in steps of 0.25V untill the last value of 0.25 V. Similar to RV threshold testing, the testing rate is 90 bpm at the programmed polarity (LV-tip to RV-coil in this case) and pulse width (0.35 ms by default). Once the test is performed, the tracing is frozen and it is possible to reanalyze the EGM. The selected threshold values are the last amplitude values (Volt) which captured the LV. Click on the corresponding pacing output, or select it with the right or left arrow keys on the keyboard (blue bar in the figure below). It is necessary to save the test results after each test, these being reported in the test assistant table and in the \u00ab Leads \u00bb table of the \u00ab Summary \u00bb screen. See live examples of LV threshold testing in <a href=\"https:\/\/microportacademycrm.com\/courses\/crt-interrogation\/\">our interrogation videos<\/a>. After the LV threshold test, the phrenic nerve stimulation threshold can be stored (when present) together with the left pacing threshold. When multipoint pacing is enabled, the pacing test is divided into LV MP1 and LV MP2 as programmed. However, multipoint pacing (pacing the LV at multiple sites) is currently not recommended as it uses more energy and it&#8217;s benefits remain to be shown.<\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p27.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-24381 size-large\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p27-1024x691.jpg\" alt=\"\" width=\"625\" height=\"422\" \/><\/a><\/p><p style=\"text-align: center;\"><strong>In this example the LV-tip to RV-coil pacing threshold is 1.25V. There was no phrenic nerve stimulation (PNS), PNS &#8220;No&#8221; was selected but this is not mandatory, it will show up empty in the list when nothing is saved. However it is important to save the value at which PNS occurs, as this makes selecing the best vector easier.\u00a0<\/strong><\/p><p><strong>LV pacing vectors<\/strong><\/p><p>The next tab in the tests screen is \u00ab LV Vectors \u00bb. The assistant displays the following: in the table on the left of the screen, are shown \u00a0the last impedance measurements for each vector, the LV pacing threshold, and the phrenic nerve stimulation (PNS) threshold, and on the right of the screen, the LV vector(s) and LV pacing parameters that are currently programmed. Simply check the vectors in the table on the left that you wish to test, choose the test rate, then click on \u00ab LV test: Start \u00bb to begin. The threshold test screen opens and click start to run the test. The pacing and possibly the phrenic nerve thresholds are recorded, then click on the \u00ab NEXT \u00bb button to test the following vector and so on. At the end of the tests, the LV Vectors screen displays the results. You can then select the vector(s) you wish to program, then click on \u00ab Apply \u00bb and display the Brady parameters screen. The selected values \u200b\u200bappear in yellow. Click on the \u00ab Prog \u00bb button to program the selection.<\/p><h2><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p28.jpg\"><img decoding=\"async\" class=\"aligncenter wp-image-24383 size-large\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p28-1024x768.jpg\" alt=\"\" width=\"625\" height=\"469\" \/><\/a><\/h2><p style=\"text-align: center;\"><strong>The LV vectors screen enables a quick overview of impedances, LV pacing thresholds and phrenic nerve stimulation (PNS) thresholds. Multiple vectors may be selected and tested semi-automatically one-by-one.\u00a0<\/strong><\/p><p><strong>EGM Tab<\/strong><\/p><p>The last tab, \u00ab LV Vectors \u00bb allows you to view the atrial and RV EGMs, markers and ECG at the same time. This may be used as a final check that every is working properly, excluding intermittent RV\/LV capture problems and evaluating the presence of extrasystoles which may decrease %CRT.<\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p31.jpg\"><img decoding=\"async\" class=\"aligncenter wp-image-24384 size-large\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p31-1024x691.jpg\" alt=\"\" width=\"625\" height=\"422\" \/><\/a><\/p><p style=\"text-align: center;\"><strong>The EGM screen shows exclusively As-Bv markers, the ECG is also stable.\u00a0<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d330477 elementor-widget elementor-widget-heading\" data-id=\"d330477\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Automated LV threshold<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-794ced0 elementor-widget elementor-widget-text-editor\" data-id=\"794ced0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"rtejustify\">The function of the automated LV threshold is often very close to <a href=\"https:\/\/microportacademycrm.com\/courses\/5-pacing-and-sensing\/lessons\/stimulation\/topic\/ventricular-autothreshold-algorithm\/\">that described for the RV lead<\/a>. The threshold measurement is based on the analysis of the evoked response, or by observing the synchronization of the RV events sensed after a stimulated LV event. The threshold is measured at regular intervals, depending on the manufacturer, after which a safety margin is programmed, without further cycle-by-cycle verification of capture. It is noteworthy that Microport dual and triple chamber devices do not verify the cycle-by-cycle LV or RV lead capture.<\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/09\/LVAT.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-24045 size-full\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/09\/LVAT.jpg\" alt=\"\" width=\"803\" height=\"477\" \/><\/a><\/p><p>Example of automatic LV pacing test. LV pacing is performed with decreasing pacing output until there is a clear change in the QRS complex on the far field channel. The device recognizes a loss of capture and saves the preceding pacing output (0.75V in this case) as the LV pacing threshold.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2bc07b7 elementor-widget elementor-widget-heading\" data-id=\"2bc07b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Programming the LV lead<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-78f9a06 elementor-widget elementor-widget-text-editor\" data-id=\"78f9a06\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The \u00ab Param. \u00bb button in the function bar at the bottom of the programmer screen allows access to the programming parameters for bradycardia, tachycardia and remote monitoring. The first screen to appear is the antibradycardia pacing parameters, most of which are described in the corresponding pacemaker courses. We will discuss the pacing parameters specific to CRT.<\/p><p><strong>\u00ab SonR CRT Optimisation \u00bb tab<\/strong><\/p><p>Under the \u00ab SonR \u00bb section, we find the \u00ab SonR CRT optimisation \u00bb parameter with 4 possible options: \u00ab Off \u00bb, \u00ab Monitor \u00bb for which the algorithm processes the data and proposes optimal values, \u00ab AV \u00bb which automatically reprograms the AV delays, and \u00ab AV + VV \u00bb which automatically reprograms the AV delays and VV intervals. Find more about SonR in<a href=\"https:\/\/microportacademycrm.com\/courses\/av-vv-optimization\/\"> the AV\/VV optimization course<\/a>.<\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/SonR_screen.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-30602 size-full\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/SonR_screen.png\" alt=\"\" width=\"800\" height=\"601\" \/><\/a><\/p><p><strong>\u00ab V Chambers\/VV delay \u00bb tab<\/strong><\/p><p>Under the \u00ab Pacing\/Sensing \u00bb section, we find the \u00ab V Chambers\/VV Delay \u00bb parameter. It allows choosing monoRV (\u00ab R \u00bb), monoLV (\u00ab L \u00bb), biV ( \u00abR + L \u00bb or \u00ab L + R \u00bb pacing, defining the order of occurrence of ventricular pacing spikes if a VV interval differing from 0 is applied). The VV delay is chosen between 0 and 64 ms in incremental steps of 8 ms.<\/p><p><strong>\u00ab Multipoint LV pacing (MP) \u00bb Tab<\/strong><\/p><p>The \u00ab Multipoint LV pacing (MP) \u00bb parameter can be used if a quadripolar left ventricular lead is implanted. \u00ab Off \u00bb means that only one electrode is used as a cathode on the LV lead, i.e. the left ventricle is paced only at one site. \u00ab On \u00bb means that two LV electrodes are used as cathodes on the LV lead, enabling the left ventricule to be paced at 2 separate sites. When a quadripolar lead is implanted, 14 pacing vectors are available for the pacing polarity.<\/p><p>Between 2010 &#8211; 2020 there were many studies investigating the potential beneficial effects of MP pacing but results were controversial. The idea is that adding a second area of LV capture, the LV is activated faster, optimizing CRT. While technically true, the beneficial effects on LV pump function are highly controversial. In addition, multipoint pacing more than doubles LV pacing output, draining the battery faster. Current ESC guidelines on pacing and CRT do not recommend MP pacing.<\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/Multipoint_OFF.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-30604 size-full\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/Multipoint_OFF.png\" alt=\"\" width=\"804\" height=\"600\" \/><\/a><\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/Multipoint_ON.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-30605 size-full\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/Multipoint_ON.png\" alt=\"\" width=\"802\" height=\"602\" \/><\/a><\/p><p style=\"text-align: center;\"><strong>When clicking \u00ab On \u00bb in the \u00ab Multipoint LV pacing (MP) \u00bb tab, two LV lead electrodes are hence used as cathodes on the LV lead, with the respective LV pacing polarities, amplitude and pacing width for each of the LV pacing dipoles \u00ab MP1 \u00bb and \u00ab MP2 \u00bb appearing on the screen.<\/strong><\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/Multipoint_ON_programming.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-30606 size-full\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/Multipoint_ON_programming.png\" alt=\"\" width=\"799\" height=\"600\" \/><\/a><\/p><p style=\"text-align: center;\"><strong>Clicking on any of the \u00ab LV pacing polarity \u00bb tabs opens a new screen allowing the selection of the LV pacing electrodes, aided by a diagram. \u00a0If you wish to program, clicking on \u00ab Apply \u00bb returns to the pacing parameters screen allowing the programming of the selection made.<\/strong><\/p><p><strong>Tachy tab<\/strong><\/p><p>Under the tachy tab, the ICD parameters may be programmed, these are discussed <a href=\"https:\/\/microportacademycrm.com\/icd-courses\/\">in the ICD courses<\/a>. In CRT devices, it is possible to choose the ventricular pacing configuration for ATPs, which is independent of pacing: \u00ab R \u00bb for RV, \u00ab L \u00bb for LV, \u00ab R+L \u00bb for biV. The VV delay is forced to 0 ms during a biV ATP. It is recommended to keep this setting on &#8220;R+L&#8221; as literature indicates it is more effective. If you wish to know more about ATP, we highly recommend <a href=\"https:\/\/www.youtube.com\/watch?v=cM2DAFdNeX0\">this video by Dr Josh Cooper<\/a>.<\/p><p><a href=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p65.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-24403 size-large\" src=\"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p65-1024x768.jpg\" alt=\"\" width=\"625\" height=\"469\" \/><\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Microport &#8211; Left ventricular pacing Content General information Configuration of left ventricular stimulation The various programming options available enable the selection of a LV stimulation polarity associated with a reliable and durable myocardial capture with the least amount of power necessary in order to maximize the longevity of the device, without stimulating the phrenic nerve. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":53,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-814","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Microport CRM CRT Left Ventricular Pacing | Cardiocases<\/title>\n<meta name=\"description\" content=\"Microport CRM CRT left ventricular pacing \u2014 LV programming, output optimization &amp; real ECG tracings.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Microport CRM CRT Left Ventricular Pacing | Cardiocases\" \/>\n<meta property=\"og:description\" content=\"Microport CRM CRT left ventricular pacing \u2014 LV programming, output optimization &amp; real ECG tracings.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-02-01T08:27:18+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data1\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/\",\"name\":\"Microport CRM CRT Left Ventricular Pacing | Cardiocases\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/microportacademycrm.com\\\/wp-content\\\/uploads\\\/2022\\\/10\\\/p27-1024x691.jpg\",\"datePublished\":\"2025-07-31T14:24:09+00:00\",\"dateModified\":\"2026-02-01T08:27:18+00:00\",\"description\":\"Microport CRM CRT left ventricular pacing \u2014 LV programming, output optimization & real ECG tracings.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/#primaryimage\",\"url\":\"https:\\\/\\\/microportacademycrm.com\\\/wp-content\\\/uploads\\\/2022\\\/10\\\/p27-1024x691.jpg\",\"contentUrl\":\"https:\\\/\\\/microportacademycrm.com\\\/wp-content\\\/uploads\\\/2022\\\/10\\\/p27-1024x691.jpg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/left-ventricular-pacing-microport\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pacing &amp; Defibrillation\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Devices per company\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Microport CRM\",\"item\":\"https:\\\/\\\/cardiocases.com\\\/pacing-defibrillation\\\/devices-per-company\\\/microport-crm\\\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Left ventricular pacing Microport\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#website\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists\",\"publisher\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/cardiocases.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#organization\",\"name\":\"Cardiocases\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2025\\\/07\\\/cardiocases_logo.png\",\"contentUrl\":\"https:\\\/\\\/cardiocases.com\\\/wp-content\\\/uploads\\\/2025\\\/07\\\/cardiocases_logo.png\",\"width\":1755,\"height\":499,\"caption\":\"Cardiocases\"},\"image\":{\"@id\":\"https:\\\/\\\/cardiocases.com\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.linkedin.com\\\/company\\\/cardiocases\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Microport CRM CRT Left Ventricular Pacing | Cardiocases","description":"Microport CRM CRT left ventricular pacing \u2014 LV programming, output optimization & real ECG tracings.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/","og_locale":"fr_FR","og_type":"article","og_title":"Microport CRM CRT Left Ventricular Pacing | Cardiocases","og_description":"Microport CRM CRT left ventricular pacing \u2014 LV programming, output optimization & real ECG tracings.","og_url":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/","og_site_name":"Cardiocases","article_modified_time":"2026-02-01T08:27:18+00:00","twitter_card":"summary_large_image","twitter_misc":{"Dur\u00e9e de lecture estim\u00e9e":"11 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/","url":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/","name":"Microport CRM CRT Left Ventricular Pacing | Cardiocases","isPartOf":{"@id":"https:\/\/cardiocases.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/#primaryimage"},"image":{"@id":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/#primaryimage"},"thumbnailUrl":"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p27-1024x691.jpg","datePublished":"2025-07-31T14:24:09+00:00","dateModified":"2026-02-01T08:27:18+00:00","description":"Microport CRM CRT left ventricular pacing \u2014 LV programming, output optimization & real ECG tracings.","breadcrumb":{"@id":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/#primaryimage","url":"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p27-1024x691.jpg","contentUrl":"https:\/\/microportacademycrm.com\/wp-content\/uploads\/2022\/10\/p27-1024x691.jpg"},{"@type":"BreadcrumbList","@id":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/left-ventricular-pacing-microport\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/cardiocases.com\/"},{"@type":"ListItem","position":2,"name":"Pacing &amp; Defibrillation","item":"https:\/\/cardiocases.com\/pacing-defibrillation\/"},{"@type":"ListItem","position":3,"name":"Devices per company","item":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/"},{"@type":"ListItem","position":4,"name":"Microport CRM","item":"https:\/\/cardiocases.com\/pacing-defibrillation\/devices-per-company\/microport-crm\/"},{"@type":"ListItem","position":5,"name":"Left ventricular pacing Microport"}]},{"@type":"WebSite","@id":"https:\/\/cardiocases.com\/#website","url":"https:\/\/cardiocases.com\/","name":"Cardiocases","description":"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists","publisher":{"@id":"https:\/\/cardiocases.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/cardiocases.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/cardiocases.com\/#organization","name":"Cardiocases","url":"https:\/\/cardiocases.com\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","width":1755,"height":499,"caption":"Cardiocases"},"image":{"@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.linkedin.com\/company\/cardiocases\/"]}]}},"_links":{"self":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/pages\/814","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/comments?post=814"}],"version-history":[{"count":9,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/pages\/814\/revisions"}],"predecessor-version":[{"id":9095,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/pages\/814\/revisions\/9095"}],"up":[{"embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/pages\/53"}],"wp:attachment":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media?parent=814"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}