EDITORIALS
Importance of concordance between left ventricular pacing sites and latest activated regions: myth or reality?
Correspondence to:
Professor C Leclercq, Département de Cardiologie et Maladies Vasculaires, Centre Cardio-Pneumologique, Hôpital Pontchaillou, rue Henri Le Guilloux, 35033 Rennes Cedex 09, France; christophe.leclercq@chu-rennes.fr
See article on page 1197
Abbreviations: CRT, cardiac resynchronisation therapy; LV, left ventricular; NYHA, New York Heart Association
Keywords: cardiac dyssynchrony; cardiac resynchronisation therapy; echocardiography; heart failure; lead positioning
| The first 150 words of the full text of this article appear below. |
Cardiac resynchronisation therapy (CRT) is a well-established treatment in patients with severe and drug-refractory heart failure (New York Heart Association (NYHA) class III or IV) with severe left ventricular (LV) systolic dysfunction, dilated left ventricle and, lastly, LV dyssynchrony defined by a QRS duration 
120 ms on surface ECG.1 2 In patients selected on the basis of these criteria, CRT significantly improves symptoms, exercise tolerance and quality of life and also reduces morbidity and mortality.3–6 Despite a better comprehension of the physiopathology of cardiac dyssynchrony and technical improvements, especially in LV lead positioning in the tributary veins of the coronary sinus, a non-acceptable and stable rate of "non-responders" remains the Achilles’ heel of CRT. However, the real rate of non-responders remains difficult to evaluate, particularly because of the heterogeneity of definitions of non-responders. In the MIRACLE trial, the rate of non-responders defined by a composite definition including death, worsening of heart
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Heart 2007 93: 1197-1203.[Abstract] [Full Text] [PDF]
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