Cardiac resynchronization therapy: current trends and future directions

S Jacob; A S Bharadwaj; S S Panaich; A Mathew; L Afonso

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Cardiac resynchronization therapy: current trends and future directions

Journal article

Peer reviewed

Cardiac resynchronization therapy: current trends and future directions

S Jacob, A S Bharadwaj, S S Panaich, A Mathew and L Afonso

Minerva cardioangiologica, Vol.58(6), pp.717-729

12/2010

PMID: 21135811

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Abstract

Despite the clear cut indications for cardiac resynchronization therapy (CRT) laid down by guideline forming bodies, there are numerous unresolved issues. This review article primarily focuses on the current trends in CRT and the challenges encountered in patient selection, procedure related and postimplantation patient management issues. The high rate of non-response to CRT warrants a critical appraisal of the patient selection criteria, with the role of QRS duration and use of imaging to quantify ventricular dyssynchrony being the major points of discussion. Likewise the role of CRT in relatively asymptomatic heart failure patients, those with atrial fibrillation and the benefits of providing an implantable cardioverter defibrillator backup to all CRT devices has yet to be clearly defined. The development of effective and minimally invasive surgical techniques, dependable and reproducible means for optimal pacing site localization and comparative trials on superior mode of lead positioning, pacing sites and optimized CRT programming encompassing diverse patient populations would further advance current standards of CRT. Innovative approaches to resolve these controversies and future goal directed research is needed. Development of novel, comprehensive prediction tools to identify responders to CRT and the possibility of 'leadless' pacing would be interesting futuristic prospects.

Cardiac Resynchronization Therapy - methods

Heart Failure - therapy

Cardiac Resynchronization Therapy - trends

Atrial Fibrillation - therapy

Defibrillators, Implantable

Humans

Heart Failure - physiopathology

Treatment Outcome

Heart Failure - diagnosis

Minimally Invasive Surgical Procedures

Patient Selection

Details

Title: Subtitle: Cardiac resynchronization therapy: current trends and future directions
Creators: S Jacob - Division of Cardiology and Electrophysiology, Wayne State University/Detroit Medical Center Detroit, MI 48201, USA. jacobsony@yahoo.com
A S Bharadwaj
S S Panaich
A Mathew
L Afonso
Resource Type: Journal article
Publication Details: Minerva cardioangiologica, Vol.58(6), pp.717-729
PMID: 21135811
ISSN: 0026-4725
eISSN: 1827-1618
Language: English
Date published: 12/2010
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094747102771

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