Author + information
- Received November 28, 2003
- Revision received January 28, 2004
- Accepted February 10, 2004
- Published online July 7, 2004.
- Jeroen J Bax, MD, PhD*,* (, )
- Gerardo Ansalone, MD†,
- Ole A Breithardt, MD‡,
- Genevieve Derumeaux, MD§,
- Christophe Leclercq, MD∥,
- Martin J Schalij, MD, PhD*,
- Peter Sogaard, MD¶,
- Martin St. John Sutton, MD# and
- Petros Nihoyannopoulos, MD, FRCP, FACC**
- ↵*Reprint requests and correspondence:
Dr. Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
Cardiac resynchronization therapy (CRT) has been proposed as an alternative treatment in patients with severe, drug-refractory heart failure. The clinical results are promising, and improvement in symptoms, exercise capacity, and systolic left ventricular (LV) function have been demonstrated after CRT, accompanied by a reduction in hospitalization and a superior survival as compared with optimized medical therapy alone. However, 20% to 30% of patients do not respond to CRT. Currently, patients are selected mainly on electrocardiogram criteria (wide QRS complex, left bundle branch block configuration). In view of the 20% to 30% of nonresponders, additional selection criteria are needed. Echocardiography (and, in particular, tissue Doppler imaging) may allow further identification of potential responders to CRT, based on assessment of inter- and intraventricular dyssynchrony. In addition, echocardiography may allow optimal LV lead positioning and follow-up after CRT. In the current review, the different echocardiographic approaches to predict response to CRT are discussed. In addition, the use of echocardiography to guide LV lead positioning and follow-up after CRT are addressed.
- Received November 28, 2003.
- Revision received January 28, 2004.
- Accepted February 10, 2004.
- American College of Cardiology Foundation