In the past, the most important contraindication in<unk>  treatment was permanent and long-standing persistent atrial fibrillation. The signal application in current<unk>  devices was timed and triggered according to the electrical activity of the atrium. In atrial fibrillation, electrical activity in the atrium is severely disturbed and is therefore not a reliable basis for the triggering of<unk>  signals. This also applies to other diseases involving severe disturbance in electrical atrial sensing. Requests have been raised in scientific literature for an improved<unk>  algorithm which would allow the therapy to be delivered independently from any atrial signal. A pioneering study had shown that an improved<unk>  algorithm could make the therapy an effective treatment for patients with persistent atrial fibrillation. Following these study results the new generation was developed and can now offer<unk>  therapy also for patients with atrial fibrillation. Other irregular rhythms, including frequent premature ventricular contractions (ventricular extra systoles) or a distinct signal transduction disorder in the heart (untreated AV block of more than 300 ms), may represent contraindications. CRT treatment should be considered in lieu of<unk>  in patients with left bundle branch block (LBBB) and a QRS duration of over 120 ms, or when the QRS duration is greater than 150 ms and independent of LBBB. As with conventional pacemaker therapy, the<unk>  device cannot be implanted if the leads cannot be positioned appropriately in the heart. In cases where there is an artificial heart valve between the right atrium and ventricle (a mechanical prosthetic tricuspid valve), the valve function could be greatly affected by the ventricular leads. In some instances it may be impossible to guide the leads through the main veins in the upper half of the body to the heart due to venous thrombosis, for example VVI pacemakers, in the case of 100% stimulation, are also contraindicated.
Cardiac contractility modulation
Vascular recruitment
Isolytic muscle contraction
Neural facilitation
Local blood flow regulation
Vasodilation
Vasoconstriction
Cardioprotection