Key result
Patient selection, LV lead location, multipoint pacing, and AV/VV optimization predict better CRT response rates.
Why the study?
Although cardiac resynchronization therapy improves clinical outcomes in heart failure, about one-third of recipients are non-responders.
This review summarizes the clinical, pre-procedural, intra-procedural, and post-procedural determinants of a favorable response to cardiac resynchronization therapy to help reduce the rate of non-responders.
Cardiac resynchronization therapy (CRT) is a well-established treatment modality for ambulatory patients with heart failure (HF) who have prolonged QRS, left bundle branch block, reduced left ventricular (LV) ejection fraction, and New York Heart Association class II-IV. CRT has been shown to induce reverse LV remodeling and improve HF symptoms and clinical outcomes. About one-third of CRT recipients are considered non-responders. Patient selection, LV lead location, LV lead selection, multipoint pacing, and optimization of the atrioventricular and ventriculo-ventricular intervals were all shown to be associated with a better CRT response rate. Herein, we review the determinants of CRT response.
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Allison et al. (2022) conducted a review in Heart failure with reduced ejection fraction and electrical dyssynchrony. Cardiac resynchronization therapy (CRT) was evaluated. Patient selection, left ventricular lead location, multipoint pacing, and optimization of atrioventricular and ventriculo-ventricular intervals are key determinants associated with a better response rate to cardiac resynchronization therapy.
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