Cardiac resynchronization therapy update: evolving indications, expanding benefit?

Butcher, C., Mareev, Y., Markides, V., Mason, M., Wong, T. and Cleland, J.G.F. (2015) Cardiac resynchronization therapy update: evolving indications, expanding benefit? Current Cardiology Reports, 17(10), 90. (doi: 10.1007/s11886-015-0641-5) (PMID:26298308)

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Abstract

Cardiac resynchronisation therapy (CRT) is an effective intervention for appropriately selected patients with heart failure, but exactly how it works is uncertain. Recent data suggest that much, or perhaps most, of the benefits of CRT are not delivered by re-coordinating left ventricular dyssynchrony. Atrio-ventricular resynchronization, reduction in mitral regurgitation and prevention of bradycardia are other potential mechanisms of benefit that will vary from one patient to the next and over time. Because there is no single therapeutic target, it is unlikely that any single measure will accurately predict benefit. The only clinical characteristic that appears to be a useful predictor of the benefits of CRT is a QRS duration of >140 ms. Many new approaches are being developed to try to improve the effectiveness of and extend the indications for CRT. These include smart pacing algorithms, better pacing-site targeting, new sensors, multipoint pacing, remote device monitoring and leadless endocardial pacing. Whether CRT is effective in patients with atrial fibrillation or whether adding a defibrillator function to CRT improves prognosis awaits further evidence.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Butcher, C., Mareev, Y., Markides, V., Mason, M., Wong, T., and Cleland, J.G.F.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Current Cardiology Reports
Publisher:Springer
ISSN:1523-3782
ISSN (Online):1534-3170
Published Online:23 August 2015

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