Established and evolving indications for cardiac resynchronisation

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.

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.