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Pacing interventions in non-responders to cardiac resynchronization therapy.


ABSTRACT: Non-responders to Cardiac Resynchronization Therapy (CRT) represent a high-risk, and difficult to treat population of heart failure patients. Studies have shown that these patients have a lower quality of life and reduced life expectancy compared to those who respond to CRT. Whilst the first-line treatment for dyssynchronous heart failure is "conventional" biventricular epicardial CRT, a range of novel pacing interventions have emerged as potential alternatives. This has raised the question whether these new treatments may be useful as a second-line pacing intervention for treating non-responders, or indeed, whether some patients may benefit from these as a first-line option. In this review, we will examine the current evidence for four pacing interventions in the context of treatment of conventional CRT non-responders: CRT optimization; multisite left ventricular pacing; left ventricular endocardial pacing and conduction system pacing.

SUBMITTER: Wijesuriya N 

PROVIDER: S-EPMC9909021 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Pacing interventions in non-responders to cardiac resynchronization therapy.

Wijesuriya Nadeev N   Elliott Mark K MK   Mehta Vishal V   De Vere Felicity F   Strocchi Marina M   Behar Jonathan M JM   Niederer Steven A SA   Rinaldi Christopher A CA  

Frontiers in physiology 20230126


Non-responders to Cardiac Resynchronization Therapy (CRT) represent a high-risk, and difficult to treat population of heart failure patients. Studies have shown that these patients have a lower quality of life and reduced life expectancy compared to those who respond to CRT. Whilst the first-line treatment for dyssynchronous heart failure is "conventional" biventricular epicardial CRT, a range of novel pacing interventions have emerged as potential alternatives. This has raised the question whet  ...[more]

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