Cardiac resynchronisation therapy in heart failure
Keywords:
chronic heart failure, cardiac resynchronisation therapy, electro-mechanical dyssynchrony, defibrillator, left bundle branch block, ventricular conduction disturbanceAbstract
Abstract: Cardiac resynchronisation therapy (CRT) is a new therapeutic approach for a selected group of patients with symptomatic heart failure (NYHA III-IV) despite optimal medical therapy, due to dilated cardiomyopathy of any etiology (LVEF≤ 35%, and LVEDD≥ 55 mm), who present with electro-mechanical dyssynchrony (QRS≥ 120 msec). Safety and effectiveness of CRT have been demonstrated by several clinical trials, with patients achieving significant improvement in both clinical symptoms as well as functional status and exercise capacity. Furthermore, CRT has reduced morbidity and mortality of heart failure patients. Whether or not heart failure patients candidate to CRT should receive a defibrillator (ICD) back-up remains debatable, although growing evidence is pointing to extensive use of a defibrillator in such a population.
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