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Cardiac resynchronization therapy: when and for whom?

R.G Charles*

Cardiothoracic Centre, Liverpool, U.K.

* Correspondence: Richard G. Charles, Cardiothoracic Centre, Thomas Drive, Liverpool, L14 3PE, U.K.

Abstract

Potential candidates for cardiac resynchronization therapy (CRT) include patients with symptomatic congestive heart failure despite optimal medical therapy, who also have evidence of ventricular dyssynchrony, particularly left bundle branch block, with QRS duration in excess of 150 ms. Dyssynchrony may additionally be identified by echo-Doppler examination and tagged magnetic resonance imaging. Improved exercise capacity and quality of life, reduced sympathetic activation and fewer ventricular tachyarrhythmias are potential benefits of CRT. Ongoing trial results will be required to refine patient selection criteria and to demonstrate the possibility for prognostic as well as symptomatic benefit.

Key Words: Biventricular • cardiac pacemaker • congestive heart failure • resynchronization


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