Determinants of Response to Cardiac Resynchronization Therapy

John D Allison Jr; Yitschak Biton; Theofanie Mela

doi:10.19102/icrm.2022.130503

Determinants of Response to Cardiac Resynchronization Therapy

J Innov Card Rhythm Manag. 2022 May 15;13(5):4994-5003. doi: 10.19102/icrm.2022.130503. eCollection 2022 May.

Authors

John D Allison Jr¹, Yitschak Biton², Theofanie Mela¹

Affiliations

¹ The Demoulas Center for Cardiac Arrhythmias, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
² Cardiac Arrhythmia Service, Hadasssah Medical Center and Hebrew University in Jerusalem Medical School, Jerusalem, Israel.

Abstract

Cardiac resynchronization therapy (CRT) is a well-established treatment modality for ambulatory patients with heart failure (HF) who have prolonged QRS, left bundle branch block, reduced left ventricular (LV) ejection fraction, and New York Heart Association class II-IV. CRT has been shown to induce reverse LV remodeling and improve HF symptoms and clinical outcomes. About one-third of CRT recipients are considered non-responders. Patient selection, LV lead location, LV lead selection, multipoint pacing, and optimization of the atrioventricular and ventriculo-ventricular intervals were all shown to be associated with a better CRT response rate. Herein, we review the determinants of CRT response.

Keywords: Cardiac pacing; cardiac resynchronization therapy; heart failure.