Key result
Correction of dyssynchrony alone via cardiac resynchronisation therapy may not lead to global improvement in about one-third of patients with refractory heart failure.
Optimizing CRT outcomes in refractory heart failure may require looking beyond electromechanical dyssynchrony to include pressure relations, abnormal timing, and clinical management.
CRT optimization in refractory HF may require factors beyond dyssynchrony; leaves open multimodal strategies for nonresponders.
Cardiac resynchronisation therapy (CRT) in the form of biventricular pacing has emerged as a therapeutic option for patients with refractory heart failure. Patient selection and optimisation for CRT is based on the measurement of electromechanical ventricular dyssynchrony by electrocardiogram and echocardiographic techniques. The final common pathway for raising cardiac output on exertion is to minimise isovolumic time and maximise useful diastolic filling time, but correction of dyssynchrony alone may not lead to global improvement in about one-third of patients. Insights into pressure relations and abnormal timing, as well as clinical management, may hold the key to optimum outcome.
No takes yet. Share an insight, caveat, or question.
Chung et al. (2008) conducted a review in Refractory heart failure. Cardiac resynchronisation therapy (CRT) was evaluated. Correction of dyssynchrony alone via cardiac resynchronisation therapy may not lead to global improvement in about one-third of patients with refractory heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: