Improvement in CRT: new strategies, better choices

[摘要] Cardiac resynchronisation therapy (CRT) emerged more than a decade ago as a useful form of device therapy for heart failure associated with abnormal ventricular conduction indicated by a wide QRS complex [1, 2]. According to the Guidelines of the European Society of Cardiology (ESC) entitled Cardiac Pacing and Cardiac Resynchronization Therapy (ESC Clinical Practice Guidelines, 2013), CRT has currently a Class I indication in patients with 1) chronic heart failure (NYHA Class II-IV despite optimal medical treatment), 2) a left bundle branch block (LBBB) on the ECG with a QRS width >120 ms (preferably >150 ms), and 3) a left ventricular ejection fraction < 35 % [3]. The magnitude of CRT benefit increases in females, in patients with non-ischaemic cardiomyopathy, and in patients with a wide QRS complex: the longer the QRS duration the more favourable the response.

[学科分类] 心脏病和心血管学