Key result
Cardiac resynchronization therapy in narrow QRS systolic heart failure lacks clear benefit based on recent trials, though mechanical dyssynchrony and novel pacing techniques remain potential targets.
Why the study?
Does cardiac resynchronization therapy benefit patients with systolic heart failure and narrow QRS?
Does cardiac resynchronization therapy benefit patients with systolic heart failure and narrow QRS?
The review discusses the potential role and mechanisms of cardiac resynchronization therapy in systolic heart failure patients with narrow QRS, despite negative results from large randomized trials.
Answers are grounded in this paper and cite their sources.
CRT not indicated for narrow-QRS HF; leaves open dyssynchrony-guided or novel pacing strategies for future trials.
Cardiac resynchronization therapy has revolutionized the management of systolic heart failure in patients with prolonged QRS during the past 20 years. Initially, the use of this treatment in patients with shorter QRS durations showed promising results, which have since been opposed by larger randomized controlled trials. Despite this, some questions remain, such as, whether correction of mechanical dyssynchrony is the therapeutic target by which biventricular pacing may confer benefit in this group, or are there other mechanisms that need consideration? In addition, novel techniques of cardiac resynchronization therapy delivery such as endocardial and multisite pacing may reduce potential detrimental effects of biventricular pacing, thereby improving the benefit/harm balance of this therapy in some patients.
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Jackson et al. (2015) conducted a review in Systolic heart failure. Cardiac resynchronization therapy was evaluated. Cardiac resynchronization therapy in narrow QRS systolic heart failure lacks clear benefit based on recent trials, though mechanical dyssynchrony and novel pacing techniques remain potential targets.
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