Conduction abnormalities are noted in a number of patients with heart failure and are associated with altered ventricular mechanics (mechanical dyssynchrony), resulting in reduced and inefficient systolic function. Correction of mechanical dyssynchrony via biventricular pacing (cardiac resynchronization) is associated with substantial symptomatic benefits, reverse remodeling of the left ventricle, reduced hospitalizations for heart failure, and improved survival. However, approximately 30% of eligible patients undergoing cardiac resynchronization therapy (CRT) do not experience clinical benefits. This article discusses recent published data that suggest that assessment of mechanical synchrony with echocardiography, especially newer techniques such as tissue Doppler echocardiography (TDE), may be a reliable and accurate means of identifying patients who will best respond to CRT. In addition, MRI provides three-dimensional information on regional mechanics and may emerge as an important technique for assessment of dyssynchrony.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine