Guiding left ventricular lead positioning and refining ability to predict response and nonresponse to cardiac resynchronization therapy using dP/dt max: killing 3 birds with 1 high-fidelity wire?

摘要

Prediction of nonresponse. Despite our ability to recognize patients with high likelihood of response to CRT well, the major challenge lies in predicting the long-term nonresponse to CRT. In the study by Duckett et al. (8), specificity or the ability of the increase in LV-dP/dt_(max) >=10% with CRT to detect the nonresponder at 6 months (64%) was not better than the specificity of baseline QRS duration >146 ms (64%) or interventricular mechanical delay >=40 ms (86%). Baseline QRS >150 ms by itself has been reported to have a higher specificity of 80% in predicting nonresponse to CRT (12).