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Updated: Sep 13, 2025

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
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Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

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Prediction of response to cardiac resynchronization therapy using electrocardiographic criteria: A systematic review

Paulo Dias Costa1, João Pedro Bessa2, Mariana Canelas Pais3

  • 1Center for Health Technology and Services Research, Porto, Portugal; Department of Community Medicine, Information and Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|July 25, 2025
PubMed

Insights

Standard electrocardiograms (ECG) can predict response to cardiac resynchronization therapy (CRT). Contemporary ECG parameters show promise in identifying patients who will benefit from CRT, though further validation is needed.

Area of Science:

  • Cardiology
  • Medical Technology

Background:

  • Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
  • Approximately 30% of patients do not respond to CRT.
  • Standard electrocardiograms (ECG) are used to assess CRT response, but evidence is conflicting.

Purpose of the Study:

  • To systematically review real-world studies.
  • To assess the value of pre-implantation standard ECG parameters in predicting CRT response.

Main Methods:

  • Systematic review of studies.
  • Searched PubMed, Scopus, and Web of Knowledge.
  • Synthesized results using evidence tables.

Main Results:

  • Included 62 eligible articles.
  • Traditional predictors: QRS duration ≥150 ms, left bundle branch block.
  • Contemporary predictors: QRS notching/fragmentation, S wave assessment, time to intrinsicoid deflection, lead one ratio ≥12.

Conclusions:

  • Standard ECG shows promise for predicting CRT response.
  • Contemporary ECG parameters are particularly promising.
  • Further research is needed to validate these predictors.
Abstract

Keywords:
Cardiac resynchronization therapyHeart failureInsuficiência cardíacaPatient selectionRevisão sistemáticaSeleção de doentesSystematic reviewTerapêutica de ressincronização cardíaca

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