Limited Response to Cardiac Resynchronization Therapy in Patients with Concomitant Right Ventricular Dysfunction

Abstract

RVD represents a strong predictor of lack of clinical response to CRT in patients with CHF due to LVD and should be considered when prescribing CRT.

Right ventricular function and survival following cardiac resynchronisation therapy

“…Scuteri et al 19 have shown in a small group of patients that TAPSE is predictive of reverse LV remodelling following CRT. Among 130 CRT recipients, Tabereaux et al 20 recently demonstrated RV dysfunction to be an independent predictor of a heterogeneous composite adverse outcome including death, transplantation, need for LV assist device, lack of improvement in NYHA class and hospital care. Field et al 21 reported similar findings using RV myocardial performance as measurement of RV function.…”

A new score system for predicting response to cardiac resynchronization therapy

“…Impairment of RV systolic function has been consistently associated with worse outcomes in patients with advanced heart failure, independently of LV function [20]. Previous studies reported that RV dysfunction represented a strong predictor of lack of clinical response to CRT [21][22][23]. In the present study, we used TAPSE, a simple, less dependent on optimal image quality and reproducible method to assess RV function and found that TAPSE was a strong variable to predict CRT response.…”

The Emerging Role of Cardiac Resynchronization Therapy in Milder Heart Failure: Are We Implanting Too Late for Response?

“…As patients develop progressive LV dysfunction, associated RV dysfunction also may develop. Evidence from recent studies suggests that RV dysfunction may be a further predictor of poor response to CRT [43]. Increased infarct size also may affect response, as it is known that patients with infarcted posterolateral walls have worse outcomes with CRT [44,45].…”