An echocardiography-based technique for screening cardiac resynchronization therapy patients: deja vu all over again?

摘要

Cardiac resynchronization therapy (CRT) has become an established treatment for patients with left ventricular (LV) systolic failure, congestive heart failure symptoms, and electrical evidence of ventricular dyssynchrony. CRT reduces both morbidity and mortality in appropriate patients, with durable benefits demonstrated in multiple large, prospective, randomized trials. However, one of the frustrat-ingly persistent limitations of CRT is the significant nonre-sponder rate. Defining "response" admittedly is difficult because disease nonprogression or retardation may represent some form of salutary CRT effect. Nevertheless, it is generally accepted that the CRT nonresponder rate is somewhere between 20% and 50%, depending on the metrics used for assessment.