Established and evolving indications for cardiac resynchronisation

H J Nesser¹, O-A Breithardt², B K Khandheria³

¹ Public Hospital Elisabethinen, Department of Cardiology, Academic Teaching Hospital of the University of Vienna and Innsbruck, Linz, Austria
² Klinikum Mannheim, I. Medizinische Klinik, Mannheim, Germany
³ Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota, USA

Correspondence to:
Correspondence to:
Dr Hans Joachim Nesser
Public Hospital Elisabethinen, Department of Cardiology, Academic Teaching Hospital of the University of Vienna and Innsbruck, A-4020 Linz, Fadingerstrasse 1, Austria; hans-joachim.nesser{at}elisabethinen.or.at

Randomised trials involving large number of patients have demonstrated the benefits of cardiac resynchronisation therapy (CRT) in patients with heart failure who have failed optimal medical treatment. Echocardiography plays an important role in defining dyssynchrony which is key to optimal patient selection. The electrocardiographic criteria for patient selection is supplemented by the finding of dyssynchrony on Doppler myocardial imaging, and echocardiography with Doppler myocardial imaging may eventually replace the electrocardiographic criteria for selection of patients who derive benefit from CRT.

Abbreviations: AF, atrial fibrillation; AHI, apnoea hypopnoea index; BiV, biventricular; CHF, congestive heart failure; CRT, cardiac resynchronisation therapy; CSA, central sleep apnoea; Cum% VP, cumulative percent ventricular paced; DAVID, dual chamber and VVI implantable defibrillator; FMR, functional mitral regurgitation; ICD, implantable cardioverter-defibrillator; LBBB, left bundle branch block; LVEF, left ventricular ejection fraction; MIRACLE, multicentre InSync randomized clinical evaluation; MUSTIC, multisite stimulation in cardiomyopathy; NYHA, New York Heart Association; Path-CHF, pacing therapies for congestive heart failure; RBBB, right bundle branch block; SR, sinus rhythm; TDI, tissue Doppler imaging; VT, ventricular tachycardia

Keywords: atrial fibrillation; cardiac resynchronisation therapy; congestive heart failure

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