Journal Article

How to discriminate responders from non-responders to cardiac resynchronisation therapy

Christoph Stellbrink, Ole-Alexander Breithardt, Anil-Martin Sinha and Peter Hanrath

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 6, issue suppl_D, pages D101-D105
Published in print August 2004 | ISSN: 1520-765X
Published online August 2004 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/j.ehjsup.2004.05.008
How to discriminate responders from non-responders to cardiac resynchronisation therapy

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Cardiac resynchronisation therapy (CRT) has been increasingly accepted as an adjunct therapy to drug treatment for heart failure patients with ventricular conduction delay. Nevertheless, using implant criteria from current guidelines, 20–30% of patients show no or only minor functional benefit. One important reason for this is the fact that these criteria rely mainly on QRS width as a measure of left ventricular dyssynchrony. However, QRS width may not always correlate well to mechanical dyssynchrony which is the main abnormality to be treated by CRT. Several methods have been proposed to assess left ventricular dyssynchrony, such as cardiac magnetic resonance imaging (MRI) or echocardiography. Because MRI is not repeatedly available in pacemaker patients, echocardiography is emerging as the most promising technique both for the identification of therapy responders and the assessment of optimal CRT delivery. However, none of the proposed echocardiographic criteria has yet been validated in prospective trials. This review summarizes the current knowledge on the optimal identification of therapy responders to CRT.

Keywords: Cardiac resynchronisation therapy; Pacemaker; Heart failure; Left bundle branch block

Journal Article.  2807 words.  Illustrated.

Subjects: Cardiovascular Medicine

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