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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

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Developments in Cardiac Resynchronisation Therapy

Geoffrey F Lewis1, Michael R Gold1

  • 1Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina, US.

Arrhythmia & Electrophysiology Review
|February 3, 2016
PubMed

Insights

Cardiac resynchronisation therapy (CRT) improves outcomes for heart failure patients with reduced ejection fraction and conduction delays. Maximizing CRT response involves refining patient selection, optimizing lead placement, and adopting new delivery techniques.

Area of Science:

  • Cardiology
  • Medical Devices

Background:

  • Cardiac resynchronisation therapy (CRT) is established for heart failure with reduced ejection fraction (HFrEF) and interventricular conduction delay.
  • Large trials confirm CRT reduces heart failure hospitalizations, improves symptoms, left ventricular (LV) function, and mortality.
  • Guidelines recommend CRT for NYHA class II-IV HFrEF patients with QRS prolongation, especially left bundle branch block.

Purpose of the Study:

  • To address the challenge of maximizing patient response rates and magnitude to CRT.
  • To explore strategies for optimizing CRT effectiveness in eligible heart failure patients.

Main Methods:

  • Review of established CRT indications and current clinical challenges.
  • Discussion of emerging strategies including tailored patient selection.
  • Exploration of individualized LV lead placement techniques.
  • Consideration of novel technologies and methods for CRT delivery.

Main Results:

  • CRT is proven to significantly improve clinical outcomes in selected heart failure patients.
  • Current focus is on enhancing CRT efficacy beyond established criteria.
  • Optimizing patient selection and lead positioning are key to improving response.

Conclusions:

  • Maximizing CRT benefits requires a multi-faceted approach.
  • Tailoring patient selection and individualizing LV lead placement are critical.
  • Advancements in CRT delivery technologies hold promise for further improving patient outcomes.

Keywords:
Cardiac resynchronisation therapyLV lead deliveryLV reverse remodellingcardiac pacemakerdevice programmingheart failureimplantable cardioverter/defibrillatorleft bundle branch blockleft ventricular function

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