European Heart Journal Advance Access originally published online on June 26, 2007
European Heart Journal 2007 28(15):1790-1792; doi:10.1093/eurheartj/ehm254
© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Predicting outcome in severe heart failure. Who will benefit from device therapy (CRT)?
1 Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland; New Zealand
2 Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
* Corresponding author. Tel: +64 9 373 7599 ext. 89804; fax: +64 9 367 7146. E-mail address: r.doughty@auckland.ac.nz
This editorial refers to ‘Predictors and treatment response with cardiac resynchronization therapy in patients with heart failure characterized by dyssynchrony: a pre-defined analysis from the CARE-HF trial’ by M. Richardson et al., on page 1827
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Dyssynchronous ventricular contraction in severe heart failure contributes to low cardiac output, worsening symptoms, and poor prognosis. Recognition of the effect of dyssynchrony in heart failure, and the possibility of manipulating the sequence of electrical cardiac activation to improve the efficiency of mechanical events, led Cazeau et al. to attempt four-chamber pacing in 1994.1 This early system could stimulate both atria and both ventricles extrinsically, and could dictate the temporal relationship between atrial systole and ventricular systole, and the ventriculo-ventricular relationship. Modern cardiac resynchronization therapy (CRT), involving pacing of the right and left ventricles, with right atrial pacing to optimize atrio-ventricular delay, has evolved rapidly from this beginning.
Left bundle branch block (LBBB) on the surface electrocardiogram (ECG) has been considered a marker of mechanical dyssynchrony as it represents a delay in conduction of depolarization to the left ventricle, with the greatest delay usually being in
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Related articles in EHJ:
- Predictors and treatment response with cardiac resynchronization therapy in patients with heart failure characterized by dyssynchrony: a pre-defined analysis from the CARE-HF trial
- Matthew Richardson, Nick Freemantle, Melanie J. Calvert, John G.F. Cleland, Luigi Tavazzi, and on behalf of the CARE-HF Study Steering Committee and Investigators
EHJ 2007 28: 1827-1834.[Abstract] [FREE Full Text]
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