Key result
Multi-modality imaging provides important information on heart failure aetiology, myocardial scar, and conduction delay mechanisms to guide cardiac implantable electronic device therapy.
Why the study?
Device assessment in heart failure relies primarily on left ventricular ejection fraction, despite multi-modality imaging offering insights into etiology, myocardial scar, and conduction delays.
Does multi-modality imaging improve the selection of heart failure patients for cardiac implantable electronic devices compared to standard LVEF assessment?
Does multi-modality imaging improve the selection of heart failure patients for cardiac implantable electronic devices compared to standard LVEF assessment?
Multi-modality imaging offers potential beyond LVEF to identify heart failure patients who will benefit from ICD and CRT, though boundaries to its application remain.
Heart failure is a clinical syndrome with an increasing prevalence and incidence worldwide that impacts patients' quality of life, morbidity, and mortality. Implantable cardioverter-defibrillator and cardiac resynchronization therapy are pillars of managing patients with HF and reduced left ventricular ejection fraction. Despite the advances in cardiac imaging, the assessment of patients needing cardiac implantable electronic devices relies essentially on the measure of left ventricular ejection fraction. However, multi-modality imaging can provide important information concerning the aetiology of heart failure, the extent and localization of myocardial scar, and the pathophysiological mechanisms of left ventricular conduction delay. This paper aims to highlight the main novelties and progress in the field of multi-modality imaging to identify patients who will benefit from cardiac resynchronization therapy and/or implantable cardioverter-defibrillator. We also want to underscore the boundaries that prevent the application of imaging-derived parameters to patients who will benefit from cardiac implantable electronic devices and orient the choice of the device. Finally, we aim at providing some reflections for future research in this field.
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Galli et al. (2022) conducted a review in Heart failure. Multi-modality imaging was evaluated. Multi-modality imaging provides important information on heart failure aetiology, myocardial scar, and conduction delay mechanisms to guide cardiac implantable electronic device therapy.
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