Real-Time 3D Echo in Patient Selection for Cardiac Resynchronization Therapy

Abstract

the LVMD quantification by 3D echo is reproducible between centers. SDI was an excellent predictor of response to CRT in this selected patient cohort and may be valuable in identifying a target population for CRT irrespective of QRS morphology and duration.

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

“…In addition, when all the various echocardiographic measures of mechanical dyssynchrony were analyzed in a large, international multicenter study, no single measure proved capable of improving patient selection for CRT [87]. Promisingly, newer techniques including longitudinal myocardial strain assessment [88] and 3D speckle-tracking echo [89] appear more reliable and indicate an encouraging direction for future work.…”

Quantitative analysis of left ventricular dyssynchrony using cardiac computed tomography versus three-dimensional echocardiography

“…Therefore controversy has existed to date with regard to the utility of echocardiographic methods to accurately predict response to CRT. On the other hand, RT3DE may be a better predictor of CRT response than dyssynchrony measures based on tissue Doppler or conventional echocardiographic parameters, but was not investigated in the PROSPECT trial [15,[25][26][27]. Previously several investigations have shown that this method represents an echocardiographic gold standard technique for the accurate assessment of LV volumes and function and has been shown to be a accurate method for the evaluation of LV dyssynchrony [15,16,18,19].…”

“…To date however, limited data exist on the ability of this technique to assess LV dyssynchrony. In the present study we sought to compare the ability of dual-source CCT with real-time 3-dimensional echocardiography (RT3DE), an echocardiographic gold standard technique for the assessment of LV volumes and dyssynchrony [15,16], for the quantification of intraventricular LV dyssynchrony in patients with severe heart failure and left bundle branch block (LBBB) who were considered for CRT.…”

Cardiac dyssynchrony

“…More recently, Kapetanakis et al [29] investigated 187 patients from two institutions who were scheduled for CRT implant or upgrade to CRT from an existing pacemaker or defibrillator. After a mean of 7 months, they found that SDI-16 was a good predictor of echocardiographic and clinical response.…”