Tissue Doppler imaging as a guide to resynchronization therapy in patients with congestive heart failure

Purpose of review: Cardiac resynchronization therapy is a nonpharmacological treatment option in patients with heart failure and left bundle branch block but response rates are still disappointing. Recent findings: Extent of mechanical left ventricular asynchrony as detected by tissue Doppler imaging has emerged as an independent predictor of outcome to CRT. In addition, long-term therapy delivery may be further improved through optimized lead positioning and pacemaker programming. Summary: Tissue Doppler imaging should be included in the evaluation of potential CRT candidates but standardized evaluation criteria have not yet been provided.