Novel electrocardiographic dyssynchrony criteria that may improve patient selection for cardiac resynchronization therapy

作     者：Gábor Katona András Vereckei 

作者机构：Department of Medicine and HematologySemmelweis UniversityBudapestHungary 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2022年第19卷第1期

页      面：31-43页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：patient synchronization eliminate 

摘      要：Cardiac resynchronization therapy(CRT)is an evidence-based effective therapy of symptomatic heart failure with reduced ejection fraction refractory to optimal medical treatment associated with intraventricular conduction disturbance,that results in electrical dyssynchrony and further deterioration of systolic ventricular ***,the non-response rate to CRT is still 20%−40%,which can be decreased by better patient *** main determinant of CRT outcome is the presence or absence of significant ventricular dyssynchrony and the ability of the applied CRT technique to eliminate *** current guidelines recommend the determination of QRS morphology and QRS duration and the measurement of left ventricular ejection fraction for patient selection for ***,QRS morphology and QRS duration are not perfect indicators of electrical dyssynchrony,which is the cause of the not negligible non-response rate to CRT and the missed CRT implantation in a significant number of patients who have the appropriate substrate for *** imaging modalities,many ventricular dyssynchrony criteria were devised for the detection of mechanical dyssynchrony,but their utility in patient selection for CRT is not yet proven,therefore their use is not recommended for this ***,CRT can eliminate only mechanical dyssynchrony due to underlying electrical dyssynchrony,for this reason ECG has a greater role in the detection of ventricular dyssynchrony than imaging *** improve assessment of electrical dyssynchrony,we devised two novel ECG dyssynchrony criteria,which can estimate interventricular and left ventricular intraventricular dyssynchrony in order to improve patient selection for *** we discuss the results achieved by the application of these new ECG dyssynchrony criteria,which proved to be useful in predicting the CRT response in patients with nonspecific intraventricular conduction disturbance pattern(the second greatest group of CRT candidates),an