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Established and evolving indications for cardiac resynchronisation.

H J Nesser1, O-A Breithardt, B K Khandheria

  • 1Public Hospital Elisabethinen, Department of Cardiology, Academic Teaching Hospital of the University of Vienna and Innsbruck, A-4020 Linz, Fadingerstrasse 1, Austria. hans-joachim.nesser@elisabethinen.or.at

Heart (British Cardiac Society)
|November 27, 2004
PubMed
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Cardiac resynchronisation therapy (CRT) benefits heart failure patients who do not respond to medical treatment. Echocardiography with Doppler imaging may improve patient selection for CRT by identifying cardiac dyssynchrony.

Area of Science:

  • Cardiology and Cardiovascular Imaging

Background:

  • Cardiac resynchronisation therapy (CRT) is beneficial for heart failure patients unresponsive to optimal medical treatment.
  • Patient selection is crucial for CRT efficacy, with cardiac dyssynchrony being a key indicator.

Purpose of the Study:

  • To evaluate the role of echocardiography, particularly with Doppler myocardial imaging, in selecting patients for CRT.
  • To explore if echocardiographic findings can supplement or replace current electrocardiographic criteria for CRT patient selection.

Main Methods:

  • Review of randomised trials involving large patient cohorts.
  • Analysis of echocardiography and Doppler myocardial imaging in identifying cardiac dyssynchrony.
  • Comparison of echocardiographic criteria with existing electrocardiographic criteria for patient selection.

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Main Results:

  • Large-scale trials confirm CRT benefits in selected heart failure patients.
  • Echocardiography, especially with Doppler myocardial imaging, is effective in defining the cardiac dyssynchrony necessary for optimal patient selection.
  • Echocardiographic findings show potential to complement electrocardiographic criteria.

Conclusions:

  • Echocardiography with Doppler myocardial imaging is a valuable tool for identifying cardiac dyssynchrony in heart failure patients.
  • This imaging modality may eventually supersede electrocardiographic criteria for selecting patients who will benefit from cardiac resynchronisation therapy.