Echocardiography for the management of patients with biventricular pacing: Possible roles in cardiac resynchronization therapy implementation

Cardiac resynchronization therapy (CRT) is an established therapeutic option for the subset of patients with heart failure (HF), reduced ejection fraction (EF), and dyssynchrony evidenced by electrocardiography. Benefit from CRT has been proven in many clinical trials, yet a sizeable proportion of t...

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Bibliographic Details
Main Authors: Emmanouil Poulidakis, Constantina Aggeli, Konstantinos Kappos, Antonis S. Manolis, Skevos Sideris, Konstantinos Gatzoulis, Evangelos Oikonomou, Dimitrios Tousoulis
Format: Article
Language:English
Published: Elsevier 2018-11-01
Series:Hellenic Journal of Cardiology
Online Access:http://www.sciencedirect.com/science/article/pii/S1109966617306152
Description
Summary:Cardiac resynchronization therapy (CRT) is an established therapeutic option for the subset of patients with heart failure (HF), reduced ejection fraction (EF), and dyssynchrony evidenced by electrocardiography. Benefit from CRT has been proven in many clinical trials, yet a sizeable proportion of these patients with wide QRS do not respond to this intervention, despite the updated practice guidelines. Several echocardiographic indices, targeting mechanical rather than electrical dyssynchrony, have been suggested to address this issue, but research so far has not succeeded in providing a single and simple measurement with adequate sensitivity and specificity for identification of responders. While there is still ongoing research in this field, echocardiography proves helpful in other aspects of CRT implementation, such as site selection for left ventricular (LV) lead pacing and optimization of pacing parameters during follow-up visits. Keywords: Heart failure, cardiac resynchronization therapy, biventricular pacing, echocardiography
ISSN:1109-9666