Key result
Cardiac resynchronization therapy optimization and diagnostic approaches using multiple imaging modalities are reviewed to address the nearly one-third non-response rate in heart failure patients.
Why the study?
Almost one-third of heart failure patients do not respond to cardiac resynchronization therapy or gain clinical benefit, and the optimal strategy for improving response remains debatable.
This review provides an updated overview of the electropathophysiology of myocardial dysfunction and multimodality imaging approaches to optimize cardiac resynchronization therapy.
Multimodality imaging may aid CRT optimization in non-responders; leaves open prospective validation before clinical adoption.
Since the first report on biventricular pacing in 1994, cardiac resynchronization therapy (CRT) has become standard for patients with advanced heart failure (HF) and ventricular conduction delay. CRT improves myocardial function by resynchronizing myocardial contraction, which results in reverse left ventricular remodeling and improves symptoms and clinical outcomes. Despite the accelerated development of CRT device technology and its increased application in treating HF patients, almost one-third of these patients do not respond to the therapy or gain any clinical benefit from device implantation. Over the last decade, multiple cardiac imaging modalities have provided a deeper understanding of myocardial pathophysiology, thereby improving HF treatment management. However, the optimal strategy for improving the CRT response remains debatable. This article provides an updated overview of the electropathophysiology of myocardial dysfunction in ventricular conduction delay and the diagnostic approaches involving the use of multiple modalities.
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Katbeh et al. (2019) conducted a review in advanced heart failure and ventricular conduction delay. Cardiac resynchronization therapy (CRT) was evaluated. Cardiac resynchronization therapy optimization and diagnostic approaches using multiple imaging modalities are reviewed to address the nearly one-third non-response rate in heart failure patients.
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