GPS for pacemaker, ICD and CRT implants
Synchromax ® can be used before of the implantation of a resynchronizer to know if the patient will be a responder or not; during the implantation, both septal and ventricular, of any device to find the optimal stimulation site, the one that produces the best results in terms of synchrony; and during monitoring of implantable devices, to precisely and quickly adjust programmable parameters to their optimal values.
Why Synchromax® is different from anything else known
Pacemakers have always been implanted in RV because it was only possible to avoid the displacement of traditional catheters thanks to RV trabeculae.
The deleterious effect of apex stimulation of the right ventricle has been discussed for several years in different editorials (1). This effect is even greater in patients with heart failure. Non-physiological stimulation results in a blockage of the left branch that can trigger or worsen heart function in certain patients.
It is more logical and natural to stimulate from the septum, following mother nature. This was only possible when screw-in catheters appeared. However, many implanters still believe that it is difficult to find the optimal para-Hisian stimulation site. And this is partly true if we cannot evaluate the electrical synchrony immediately and non-invasively during the implant.
Until now, no one has paid attention to intraventricular electrical dyssynchrony. It was only possible to evaluate it by operator-dependent, time-consuming echocardiography.
The revolution of Synchromax® was to use the most common tool among cardiologists, the surface electrocardiogram. Using a special algorithm and from the signal provided in a non-invasive way by standard ECG electrodes, Synchromax® produces synchrony curves and a unique Cardiac Electric Synchrony Index. This index was correlated with echo and by means of intracardiac transducers.
(1) A. Manolis. The deletereous consequences of right ventricular apical pacing. Time to seek alternate site pacing. Pacing Clin. Electrophysiology 29 (2006) 298-315
Can you really resynchronize without assessing cardiac electrical asynchrony?
It is a common sense question: how can we know that we are resynchronizing a heart without establishing the degree of synchronization before and after the implant?
Evaluation of cardiac synchronization with classical methods can be cumbersome, expensive, requires additional labor, experience, and is generally time consuming. In addition, it often depends on the operator.
Today there is a new tool. Synchromax® is a simple, reliable, accurate, and non-invasive way to evaluate heart synchrony. It is based on software that acquires cardiac signals and, after averaging and processing them, produces an electrical synchronization index in conjunction with a pair of self-explanatory curves that show the degree of ventricular synchronization in real time.
Before implantation, Synchromax® helps identify patients who will not respond to CRT; during implantation of a conventional pacemaker it can make parahisian stimulation extremely easy by guiding the operator to the optimal stimulation site; and after implantation it is used to individualize the optimized programming of pacemakers, ICDs, and CRTs.
Facilitating para-Hisian stimulation: non-invasive and online evaluation of cardiac electrical asynchrony
There is now a simple, reliable, accurate and non-invasive tool to evaluate heart synchrony.
Synchromax® is based on software that acquires cardiac signals and, after averaging and processing them, produces an Electrical Synchrony Index in conjunction with a pair of self-explanatory curves that show the degree of ventricular synchrony in real time.
Some groups use special cables and sheaths, others use conventional or special active (screw-in) electrodes, but the ideal stimulation site is easily achieved by checking the synchronization in real time with Synchromax®.
His mapping or additional catheters are not necessary, which makes parahisian implants as easy and as fast as conventional right ventricular apical stimulation.
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