We usually use devices algorithms at the time of implantation and hospital discharge. In the majority of cases the automatic algorithms works well to optimize AV and VV intervals. At follow-up (4-6 months), in the case of non-response to CRT (either clinical or echocardiographic) we reprogram the device by means of echocardiography shifting from automatic algorithm to manual (echocardiography-guided) adjustment of the algorithm.
We usually use devices algorithms at the time of implantation and hospital discharge, after 6 months we perform an echocardiographic optimization if necessary (non responder patients).
The first after CRT implantation we use noninvasive thoracic impedance and then at 6 months follow-up in the case of non-response of CRT we optimize by echocardiography.