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Updated: Jun 18, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Is CRT Optimization Obsolete? A Referral Center's Experience.

Shmaila Saleem-Talib1, Mirjam D Duineveld1, Jurjan C Schipper2

  • 1Department of Cardiology, Haga Teaching Hospital, 2545 AA The Hague, The Netherlands.

Reviews in Cardiovascular Medicine
|July 30, 2024
PubMed
Summary
This summary is machine-generated.

Cardiac resynchronization therapy (CRT) optimization using echocardiography significantly improves heart failure outcomes. This method enhances left ventricular ejection fraction and New York Heart Association class in patients who did not initially respond to CRT.

Keywords:
CRT-optimizationcardiac resynchronization therapystrain rate imaging

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Area of Science:

  • Cardiology
  • Medical Devices
  • Echocardiography

Background:

  • Cardiac resynchronization therapy (CRT) is a standard treatment for heart failure (HF).
  • A significant portion of HF patients (30%) do not benefit from CRT.
  • A need exists for improved CRT optimization strategies.

Purpose of the Study:

  • To report an echocardiography-based methodology for optimizing CRT.
  • To evaluate the effectiveness of this optimization technique in a real-world clinical setting.

Main Methods:

  • A cohort of 350 ambulatory HF patients referred for CRT optimization was studied.
  • A protocol-driven echocardiographic approach was used to adjust ventriculoventricular (VV) and atrioventricular (AV) delays.
  • Left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) class changes were primary outcome measures.

Main Results:

  • Successful optimization was achieved in 82% of patients (288/350).
  • Adjustments to VV and AV timings were made, with mean values of 61% and 51%, respectively.
  • Significant improvements in LVEF and NYHA class were observed in all optimized patients.

Conclusions:

  • Echocardiography-based CRT optimization is a valuable strategy.
  • This method effectively improves LVEF and functional status (NYHA class) in HF patients.
  • CRT optimization enhances outcomes for patients receiving CRT devices.