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The simplest and cheapest tool is a fluid-filled pigtail catheter in the LV and an arterial sheath to determine either the best pacing site or the best AV-delay. It has to be emphasized that every pacing site is associated with an optimal AV-delay, thus an individualized protocol has to be run. Every patient has an individual superior pacing site.
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E/e’: > 14 is rare in normal individuals Change in mitral inflow with Valsalva: 50% change in E/A o highly specific for increased LV filling pressures o supports diagnosis of diastolic dysfunction o requires continuous recording of the Doppler signal during 10 seconds of Valsalva Difference in duration between pulmonary vein Ar ve.
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