[Cardiac resynchronization therapy: Is the ECG criterion satisfying? What are the alternative modalities?]

Area of Science:

• Cardiology
• Biomedical Engineering

Background:

• Cardiac resynchronization therapy (CRT) significantly reduces morbidity and mortality in heart failure patients with prolonged QRS duration.
• A substantial percentage of patients (30-40%) do not respond to CRT, highlighting the need for improved patient selection.

Purpose of the Study:

• To review current methods for measuring electrical and mechanical dyssynchrony.
• To evaluate the limitations of electrocardiographic and echocardiographic indices for predicting CRT response.
• To explore novel diagnostic modalities and controversial aspects of patient selection for CRT.

Main Methods:

• Literature review focusing on diagnostic modalities for cardiac dyssynchrony.
• Analysis of electrocardiographic and echocardiographic criteria for patient selection.
• Evaluation of emerging technologies for predicting CRT response.

Main Results:

• Existing electrocardiographic and echocardiographic indices for dyssynchrony have limitations.
• Newer diagnostic modalities, alongside echocardiography, show promise in reliably assessing patient suitability for CRT.
• Despite advancements, accurately selecting patients for CRT remains a significant challenge.

Conclusions:

• While echocardiography and new modalities offer improved assessment of dyssynchrony, patient selection for CRT remains complex.
• Further research is needed to refine criteria for predicting CRT response and optimize patient outcomes.