Cardiac resynchronisation therapy fails to provide objective clinical benefit in approximately 25% of patients meeting current implantation criteria.
Highlights the clinical challenge of CRT non-responders and emphasizes the importance of optimizing patient selection, lead placement, and device programming to maximize benefit.
Cardiac resynchronisation therapy has become firmly established as a treatment for patients with symptomatic heart failure. Several randomised controlled trials and numerous observational studies have demonstrated improvements in exercise capacity and quality of life. Despite these advances it is clear that approximately 25% of patients who meet current criteria for implantation of such a device do not show objective evidence of clinical benefit. Implantation of a CRT device is expensive, time consuming and involves some risk so it is important to accurately identify patients who are likely to respond and to optimise pacing lead placement and device programming to maximise the benefit in these selected patients.
David J. Fox (2005) conducted a review in symptomatic heart failure. Cardiac resynchronisation therapy was evaluated. Cardiac resynchronisation therapy fails to provide objective clinical benefit in approximately 25% of patients meeting current implantation criteria.