Understanding non-response to cardiac resynchronisation therapy: common problems and potential solutions.

Abstract:

:Heart failure is a complex clinical syndrome associated with a significant morbidity and mortality burden. Reductions in left ventricular (LV) function trigger adaptive mechanisms, leading to structural changes within the LV and the potential development of dyssynchronous ventricular activation. This is the substrate targeted during cardiac resynchronisation therapy (CRT); however, around 30-50% of patients do not experience benefit from this treatment. Non-response occurs as a result of pre-implant, peri-implant and post implant factors but the technical constraints of traditional, transvenous epicardial CRT mean they can be challenging to overcome. In an effort to improve response, novel alternative methods of CRT delivery have been developed and of these endocardial pacing, where the LV is stimulated from inside the LV cavity, appears the most promising.

journal_name

Heart Fail Rev

journal_title

Heart failure reviews

authors

Sieniewicz BJ,Gould J,Porter B,Sidhu BS,Teall T,Webb J,Carr-White G,Rinaldi CA

doi

10.1007/s10741-018-9734-8

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

41-54

issue

1

eissn

1382-4147

issn

1573-7322

pii

10.1007/s10741-018-9734-8

journal_volume

24

pub_type

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