Echocardiography for the management of patients with biventricular pacing: Possible roles in cardiac resynchronization therapy implementation

Abstract

Cardiac resynchronization therapy (CRT) is an established therapeutic option for the subset of patients with heart failure (HF), reduced ejection fraction (EF), and dyssynchrony evidenced by electrocardiography. Benefit from CRT has been proven in many clinical trials, yet a sizeable proportion of these patients with wide QRS do not respond to this intervention, despite the updated practice guidelines. Several echocardiographic indices, targeting mechanical rather than electrical dyssynchrony, have been suggested to address this issue, but research so far has not succeeded in providing a single and simple measurement with adequate sensitivity and specificity for identification of responders. While there is still ongoing research in this field, echocardiography proves helpful in other aspects of CRT implementation, such as site selection for left ventricular (LV) lead pacing and optimization of pacing parameters during follow-up visits.

A reappraisal of the role of transthoracic ultrasound in the era of COVID-19: Patient evaluation through new windows

“…2 ΤΤЕ as a readily available bedside image modality offers precise information and treatment guidance particularly in ICU patients. 3,4 Beyond the imaging protocol, the echocardiographic study must be performed according to institutional standards to prevent viral transmission and reassure operator safety. As a result, the echocardiographic examination in suspected or confirmed cases of COVID-19 should be focused but comprehensive enough to answer the diagnostic indication and the clinical question.…”