TY - JOUR
T1 - Echocardiographic evaluation of cardiac resynchronization therapy
T2 - Ready for routine clinical use? A critical appraisal
AU - Bax, Jeroen J.
AU - Ansalone, Gerardo
AU - Breithardt, Ole A.
AU - Derumeaux, Genevieve
AU - Leclercq, Christophe
AU - Schalij, Martin J.
AU - Sogaard, Peter
AU - St. John Sutton, Martin
AU - Nihoyannopoulos, Petros
PY - 2004/7/7
Y1 - 2004/7/7
N2 - 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.
AB - 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.
KW - atrioventricular
KW - AV
KW - cardiac resynchronization therapy
KW - CRT
KW - interventricular mechanical delay
KW - IVMD
KW - left ventricle/ventricular
KW - left ventricular ejection fraction
KW - LV
KW - LVEF
KW - New York Heart Association
KW - NYHA
KW - septal-to-posterior wall motion delay
KW - SPWMD
KW - TDI
UR - http://www.scopus.com/inward/record.url?scp=3242782502&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2004.02.055
DO - 10.1016/j.jacc.2004.02.055
M3 - Review article
C2 - 15234396
AN - SCOPUS:3242782502
VL - 44
SP - 1
EP - 9
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 1
ER -