Echocardiographic evaluation of cardiac resynchronization therapy: Ready for routine clinical use? A critical appraisal

Jeroen J. Bax*, Gerardo Ansalone, Ole A. Breithardt, Genevieve Derumeaux, Christophe Leclercq, Martin J. Schalij, Peter Sogaard, Martin St. John Sutton, Petros Nihoyannopoulos

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

335 Citations (Scopus)


Cardiac resynchronization therapy (CRT) has been proposed as an alternative treatment in patients with severe, drug-refractory heart failure. The clinical results are promising, and improvement in symptoms, exercise capacity, and systolic left ventricular (LV) function have been demonstrated after CRT, accompanied by a reduction in hospitalization and a superior survival as compared with optimized medical therapy alone. However, 20% to 30% of patients do not respond to CRT. Currently, patients are selected mainly on electrocardiogram criteria (wide QRS complex, left bundle branch block configuration). In view of the 20% to 30% of nonresponders, additional selection criteria are needed. Echocardiography (and, in particular, tissue Doppler imaging) may allow further identification of potential responders to CRT, based on assessment of inter- and intraventricular dyssynchrony. In addition, echocardiography may allow optimal LV lead positioning and follow-up after CRT. In the current review, the different echocardiographic approaches to predict response to CRT are discussed. In addition, the use of echocardiography to guide LV lead positioning and follow-up after CRT are addressed.

Original languageEnglish
JournalJournal of the American College of Cardiology
Issue number1
Pages (from-to)1-9
Number of pages9
Publication statusPublished - 7 Jul 2004
Externally publishedYes


  • atrioventricular
  • AV
  • cardiac resynchronization therapy
  • CRT
  • interventricular mechanical delay
  • IVMD
  • left ventricle/ventricular
  • left ventricular ejection fraction
  • LV
  • LVEF
  • New York Heart Association
  • NYHA
  • septal-to-posterior wall motion delay
  • TDI


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