Periprocedural management of cardiac resynchronization therapy

John Rickard, Niraj Varma

Research output: Contribution to journalReview article

Abstract

Cardiac resynchronization therapy (CRT) is an important therapy in heart failure but 30 % 40 % of patients may not respond. Improving this rate is an important goal and requires attention to candidate selection, intraoperative procedure, and postoperative follow-up. Factors to be considered are QRS morphology, duration, and left ventricular lead position with attention to paced effects on QRS. Postprocedure follow-up is critical to correct interfering conditions (eg, anodal capture, loss of 100 % biventricular pacing because of premature ventricular complexes (PVCs) or atrial fibrillation (AF). Echocardiographic improvement following CRT, which may take up to 18 months, is a potent predictor of long-term outcomes. Correcting the status of nonresponders, when possible, is important. Remote monitoring, in conjunction with CRT optimization clinics, may facilitate multidisciplinary follow-up and enable early intervention to improve outcome.

Original languageEnglish (US)
Article number298
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume16
Issue number4
DOIs
StatePublished - Apr 2014

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Keywords

  • Cardiac Resynchronization Therapy
  • Echocardiography
  • Heart failure
  • Left ventricular dyssynchrony
  • QRS morphology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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