Key result
Cardiac MRI and MDCT improve CRT selection by evaluating mechanical dyssynchrony, venous anatomy, and scar.
Advanced imaging techniques like MDCT and MRI may improve cardiac resynchronization therapy success rates by evaluating venous anatomy, scar tissue, and mechanical dyssynchrony.
May support refined CRT selection; leaves open need for randomized trials confirming outcome benefit.
Cardiac resynchronization therapy is a high cost therapeutic option with proven efficacy on improving symptoms of ventricular failure and for reducing both hospitalization and mortality. However, a significant number of patients do not respond to cardiac resynchronization therapy that is due to various reasons. Identification of the optimal pacing site is crucial to obtain the best therapeutic result that necessitates careful patient selection. Currently, using echocardiography for mechanical dyssynchrony assessment performs patient selection. Multi-Detector-Row Computed Tomography (MDCT) and Magnetic Resonance Imaging (MRI) are new imaging techniques that may assist the cardiologist in patient selection. These new imaging techniques have the potential to improve the success rate of cardiac resynchronization therapy, due to pre-interventional evaluation of the venous coronary anatomy, to evaluation of the presence of scar tissue, and to improved evaluation of mechanical dyssynchrony. In conclusion, clinical issues associated with heart failure in potential candidates for cardiac resynchronization therapy, and the information regarding this therapy that can be provided by the imaging techniques echocardiography, MDCT, and MRI, are reviewed.
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Sá et al. (2007) conducted a review in Heart failure requiring cardiac resynchronization therapy. Imaging techniques (Echocardiography, MDCT, MRI) was evaluated. Cardiac MRI and MDCT provide advanced three-dimensional evaluation of mechanical dyssynchrony, coronary venous anatomy, and myocardial scar tissue to improve patient selection for cardiac resynchronization therapy.
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