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Periprocedural Management of Cardiac Resynchronization Therapy

  • Heart Failure (W Tang, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion Statement

Cardiac resynchronization therapy (CRT) is an important therapy in heart failure but 30 %‒40 % of patients may not respond. Improving this rate is an important goal and requires attention to candidate selection, intraoperative procedure, and postoperative follow-up. Factors to be considered are QRS morphology, duration, and left ventricular lead position with attention to paced effects on QRS. Postprocedure follow-up is critical to correct interfering conditions (eg, anodal capture, loss of 100 % biventricular pacing because of premature ventricular complexes (PVCs) or atrial fibrillation (AF). Echocardiographic improvement following CRT, which may take up to 18 months, is a potent predictor of long-term outcomes. Correcting the status of nonresponders, when possible, is important. Remote monitoring, in conjunction with CRT optimization clinics, may facilitate multidisciplinary follow-up and enable early intervention to improve outcome.

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Conflict of Interest

Dr. John Rickard received honoraria from St. Jude Medical and travel/accommodations expenses covered or reimbursed by Medtronic Inc.

Dr. Niraj Varma received honoraria from Medtronic, St. Jude Medical, Boston Scientific, Sorin and Biotronik. Dr. Varma received payment for the development of educational presentations including service on speakers’ bureaus from Medtronic, Boston Scientific, St. Jude Medical and Biotronik. Dr. Varma received travel/accommodations expenses covered or reimbursed by St. Jude Medical, Biotronik, Medtronic, Sorin, and Boston Scientific.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Division of Cardiology, The Johns Hopkins Hospital, Baltimore, USA

    John Rickard MD, MPH

  2. Cardiac Pacing and Electrophysiology, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Niraj Varma MD

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Correspondence to Niraj Varma MD.

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This article is part of the Topical Collection on Heart Failure

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Rickard, J., Varma, N. Periprocedural Management of Cardiac Resynchronization Therapy. Curr Treat Options Cardio Med 16, 298 (2014). https://doi.org/10.1007/s11936-014-0298-1

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