Cardiac Resynchronization Therapy PDF

Preface

Cardiac resynchronization therapy (CRT) is one of the most exciting new advances in the treatment of chronic symptomatic heart failure despite optical medical treatment. In the large, randomized trials CRT has resulted in improvement in heart failure symptoms and left ventricular systolic performance in the majority of patients.

These symptomatic benefits are mediated by resynchronization of mainly the left ventricle by CRT, resulting in reverse left ventricular remodeling with a regression of LV mass, an improvement in left ventricular ejection fraction and a reduction in mitral regurgitation. These beneficial effects have recently been reported to translate in a better survival and reduced hospitalization for heart failure.

This book starts with an update on pathophysiology and treatment of heart failure, followed by an update on the results of CRT in the large, randomized trials. A specific part is dedicated to the "ABC" of CRT with chapters on implantation techniques, complications, pacemaker settings etc. Thereafter, the role of echocardiography in CRT is highlighted in various chapters. Particularly, the timely issue on the value of echocardiography in selecting patients who have a high likelihood to respond to CRT is addressed extensively. Various chapters discuss the value of new, sophisticated echocardiographic techniques to identify potential responders to CRT, including tissue Doppler imaging, strain imaging, and 3D echocardiography.

The role of echocardiography in optimization of pacemaker settings (including AV and VV optimization) is also addressed.

The final part of the book is focused on the future of CRT in expanding patient populations such as patients with atrial fibrillation, mild heart failure, or narrow QRS complex.

Cardiac Resynchronization Therapy is very clinically oriented. Particularly, the part on echocardiography is enriched with extensive cases to illustrate the theoretical basis of echocardiography and CRT.

The authors were selected on their knowledge and clinical experience in the field, and represent a broad panel of expertise both from a theoretical and clinical point-of-view. In particular, authors were selected on their leadership in heart failure, electrophysiology or echocardiography. Contributions have been provided by excellent scientists and clinicians from Europe, the United States and Asia.

The editors are grateful to all authors for their superb contributions. We feel that this book may be useful not only for specialists in heart failure, electrophysiology ot echocardiography, but also for the general clinical cardiologist. We sincerely hope that this book will provide a useful and practical handbook in the management of heart failure patients who are considered or selected for CRT.