Method and Demonstration of Direct Confirmation of Response to Cardiac Resynchronization Therapy Via Preimplant Temporary Biventricular Pacing and Impedance Cardiography

Temporary resynchronization therapy pacing is feasible, and impedance cardiography (ICG) can provide evidence of hemodynamic benefit before permanent pacemaker implantation. During an electrophysiologic study performed before permanent device implantation, a guidewire was placed in a tributary of the coronary sinus to allow pacing of the left ventricle. Temporary pacing was implemented in various modalities, during which time ICG was used to document the hemodynamic consequences of atrial pacing, dual-chamber pacing, and biventricular pacing, with biventricular pacing being hemodynamically most favorable.