Pacemaker managing therapy with

Chugh A, Scharf C, Hall B, Cheung P, Good E, Horwood L, Oral H, Pelosi F, Jr., Morady F. Prevalence and management of inappropriate detection and therapies in patients with first-generation biventricular pacemaker-defibrillators. Pacing Clin Electrophysiol 2005 28 44-50. 

Management of a Biventricular Device. It has been estimated that up to 38% of patients with moderate to severe congestive heart failure due to left ventricular systolic dysfunction have intraventricular conduction delays with wide QRS complexes and ventricular dyssynchrony (79). Cardiac resynchronization therapy using a biventricular pacemaker is now a Class I indication therapy for systolic heart failure in patients with a QRS complex > 120 ms and left ventricular ejection fraction < 35% (80). Although cardiac resynchronization therapy decreases heart failure hospitalizations (81,82), as the overall number of patients with biventricular pacemakers and ICDs increase, more critical care patients will present with implanted biventricular devices, and familiarity with the management of these devices will become increasingly important. 

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