New guidelines for cardiac resynchronisation therapy: simplicity or complexity for the doctor?

Age of cardiac resynchronisation therapy; cardiac resynchronisation therapy in elderly

I have read the article entitled “Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?” by Olechowski, et al. with great interest, recently published in Journal of Geriatric Cardiology. The investigators reported that implantation of cardiac resynchronisation therapy (CRT) is feasible and safe in very elderly despite extensive co-morbidity. I would like to emp...

Cardiac resynchronisation therapy--new treatment for heart failure.

Is Cardiac Resynchronisation Therapy Proarrhythmic?

It is well established that cardiac resynchronisation therapy (CRT) using biventricular pacing prolongs survival by its effects on pump failure. The rate of sudden cardiac death in patients undergoing CRT, however, remains high. Animal and human studies have shown that reversal of normal sequence of myocardial activation during epicardial pacing, as applied during CRT, increases the transmural ...

Stress echocardiography for selecting potential responders to cardiac resynchronisation therapy.

In the current ESC/ACC/AHA guidelines, the selection of patients for cardiac resynchronisation therapy (CRT) is based upon the QRS duration, which reflects interventricular dyssynchrony. However, about 30% of patients do not respond to CRT. It has previously been demonstrated that the presence of left ventricular mechanical dyssynchrony is predictive of response to CRT after implantation. Most ...

Utility of echocardiography for tailoring cardiac resynchronisation therapy

Cardiac resynchronisation therapy may lead to remarkable improvement in clinical status in selected patients with heart failure. However, approximately 20% of patients may not respond to this treatment. A major challenge lies in reducing the number of non-responders. Echocardiography has been the focus of growing interest for improving patient selection as well as for device optimisation. This ...