The issue of non‑responders to cardiac resynchronization therapy

Česká verzia

Authors: M. Lazárová; D. Marek; P. Heinc; M. Táborský
Authors place of work: I. interní klinika – kardiologická FN Olomouc
Published in the journal: Kardiol Rev Int Med 2014, 16(2): 106-108
Category: Cardiology Review

Summary

Cardiac resynchronization therapy (CRT) has become a big hope and an effective treatment option for patients with heart failure. Nevertheless, not all of them respond well to CRT. It is necessary to define this group of patients and identify them as non‑responders. For CRT non‑responders it is primarily necessary to arrange for adequate left ventricular stimulation as well as CRT technical parameter tuning, such as the much‑ discussed atrioventricular delay optimization. Either way, the management of CRT non‑responders also includes optimal medical therapy of heart failure and, in some indicated cases, also heart transplant.

Keywords:
heart failure – cardiac resynchronization therapy – CRT – CRT non‑responders – atrioventricular delay – AV‑ delay

Zdroje

1. Young JB, Abraham WT, Smith AL et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE‑ ICD Trial. JAMA 2003; 289: 2685– 2694.

2. Cleland JG, Daubert J‑ C, Erdmann E et al. Longer‑term effects of cardiac resynchronization therapy on mortality in heart failure (the CArdiac REsynchronization‑ Heart Failure [CARE‑ HF] trial extension phase). Eur Heart J 2006; 27: 1928– 1932.

3. Tang ASL, Wells GA, Talajic M et al. Cardiac‑ Resynchronization Therapy for Mild‑ to‑ Moderate Heart Failure. N Engl J Med 2010; 363: 2385– 2395. doi: 10.1056/ NEJMoa1009540.

4. Beshai JF, Grimm RA, Nagueh SF et al. Cardiac‑ resynchronization therapy in heart failure with narrow QRS complexes. N Engl J Med 2007; 357: 2461– 2471.

5. Abraham WT, Fisher WG, Smith AL et al. Cardiac resynchronization in chronic heart failure. N Engl J Med 2002; 346: 1845– 1853.

6. Cleland JG, Tageldien A, Buqa L et al. Should We Be Trying to Define Responders to Cardiac Resynchronization Therapy? JACC 2010; 3: 541– 549. doi: 10.1016/ j.jcmg.2010.04.003.

7. Kutyifa V, Breithardt OA. How to Assess the Nonresponder to Cardiac Resynchronization Therapy‑ A Comprehensive Stepwise Approach. Rev Esp Cardiol 2012; 65: 504– 510. doi: 10.1016/ j.recesp.2011.12.024.

8. Hardt SE, Yazdi SH, Bauer A et al. Immediate and chronic effects of AV‑ delay optimization in patients with cardiac resynchronization therapy. Int J Cardiol 2007; 115: 318– 325.