Tissue Doppler echocardiography and biventricular pacing in heart failure: patient selection, procedural guidance, follow-up, quantification of success

Cardiovascular Ultrasound
F KnebelA C Borges

Abstract

Asynchronous myocardial contraction in heart failure is associated with poor prognosis. Resynchronization can be achieved by biventricular pacing (BVP), which leads to clinical improvement and reverse remodeling. However, there is a substantial subset of patients with wide QRS complexes in the electrocardiogram that does not improve despite BVP. QRS width does not predict benefit of BVP and only correlates weakly with echocardiographically determined myocardial asynchrony. Determination of asynchrony by Tissue Doppler echocardiography seems to be the best predictor for improvement after BVP, although no consensus on the optimal method to assess asynchrony has been achieved yet. Our own preliminary results show the usefulness of Tissue Doppler Imaging and Tissue Synchronization Imaging to document acute and sustained improvement after BVP. To date, all studies evaluating Tissue Doppler in BVP were performed retrospectively and no prospective studies with patient selection for BVP according to echocardiographic criteria of asynchrony were published yet. We believe that these new echocardiographic tools will help to prospectively select patients for BVP, help to guide implantation and to optimize device programming.

References

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Citations

Apr 7, 2006·Herzschrittmachertherapie & Elektrophysiologie·A C BorgesG Baumann
Apr 3, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Fabian KnebelAdrian C Borges
Dec 27, 2005·Expert Review of Cardiovascular Therapy·Michael S Panutich, Bradley P Knight
Sep 24, 2005·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Safwat Gassis, Angel R León

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Methods Mentioned

BETA
imaging techniques

Software Mentioned

Tissue Tracking

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