Echo of the month. A child with cyanosis.

摘要

Cardiac resynchronization therapy (CRT) using atrio-biventricular pacing has evolved into a useful therapeutic option for patients with heart failure, refractory to optimal medical therapy. Improvements in quality of life, morbidity, mortality, severity of mitral regurgitation (MR) and left ventricular (LV) function have been demonstrated in large randomized clinical trials but the treatment is invasive and expensive. Besides, about one third of patients remain unresponsive in spite of the device implantation using the existing criteria. There is thus a need to carefully identify the patients most likely to benefit by this intervention using indices of mechanical dyssynchrony.