Boston scientific received information that due to the markers on the electrogram (egm), there was concern over possible left ventricular (lv) lead loss of capture (loc).It was noted that the output had been decreased at the previous visit due to chest wall stimulation.The other manufacturer's lv lead threshold measurements had increased.The patient was noted to be ventricular dependent, but was pacing in the right ventricle without issue and there were no adverse patient effects.The patient was brought back into the clinic where they repeated lv threshold testing and changed the sensing vector.Two months later the patient contacted the clinic with complaints of feeling "a little bit off." review of the remote home monitoring data found that there was now lv loc in the previously programmed vector.Boston scientific technical services (ts) was consulted and suggested bringing the patient in to test other vectors and possibly increase the output.The clinic opted to have the patient performed another transmission which showed lv capture.The physician has opted to continue to monitor the patient for now and will have the patient come into the clinic when normally scheduled.The patient was asymptomatic.The cardiac resynchronization therapy pacemaker (crt-p) and lv lead remain in service.
|