LAUSR

Most devices that deliver cardiac resynchronization therapy (CRT) are left at nominal settings after implant, since guidelines do not advocate for routine postimplant optimization in the absence of convincing benefit. However, ventricular activation patterns during intrinsic conduction and responses to right ventricular (RV) and left ventricular (LV) pacing vary among different patients. Thus optimizing electrical resynchronization may need Introduction Maximizing efficacy and avoiding nonresponse are important aims of cardiac resynchronization therapy (CRT) delivery. Current recommendations emphasize careful candidate selection and left ventricle (LV) lead delivery but do not extend to postimplant optimization in the absence of convincing benefit. However, optimizing electrical resynchronization depends on the interaction between patient substrate and paced effects and may need individualization. Recent data indicate that “Triple Fusion” optimizes CRT delivery. However, this strategy has never been visually depicted. individualization according to the interaction between patient substrate and paced effects.