How to Perform CRT Optimization
Congestive heart failure (CHF) is a resource-intensive and costly chronic disease. Current indications for implantation of cardiac resynchronization therapy (CRT) include the presence of severe cardiomyopathy and evidence of ventricular conduction delay on ECG with symptoms of CHF despite medications. Numerous studies have demonstrated the benefit of CRT in improving cardiovascular hemodynamics, functional capacity, and decreasing mortality. However, up to one-third of patients do not experience any improvement. Patients classified as non-responders to CRT are frequently sent for echocardiographic optimization of the device's atrioventricular (AV) and interventricular (VV) intervals. This chapter reviews the data behind and techniques for CRT optimization.
