Cardiac Resynchronization Therapy: An Overview on Guidelines

Card Electrophysiol Clin. 2015 Dec;7(4):673-93. doi: 10.1016/j.ccep.2015.08.015. Epub 2015 Oct 1.

Abstract

Cardiac resynchronization therapy (CRT) is included in international consensus guidelines as a treatment with proven efficacy in well-selected patients on top of optimal medical therapy. Although all the guidelines strongly recommend CRT for LBBB with QRS duration greater than 150 milliseconds, lower strength of recommendation is reported for QRS duration of 120 to 150 milliseconds, especially if not associated with LBBB. CRT is not recommended for a QRS of less than 120 milliseconds. No indication emerges for guiding the implant based on echocardiographic evaluation of dyssynchrony. Many data indicate that CRT is underused and there is heterogeneity in its implementation.

Keywords: Atrial fibrillation; Bundle branch block; Cardiac resynchronization therapy; Guidelines; Heart failure; QRS interval.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Bundle-Branch Block / complications
  • Bundle-Branch Block / diagnosis
  • Bundle-Branch Block / prevention & control*
  • Cardiac Resynchronization Therapy / standards*
  • Cardiology / standards
  • Electrocardiography / standards*
  • Heart Failure / complications
  • Heart Failure / diagnosis
  • Heart Failure / prevention & control*
  • Humans
  • Internationality
  • Patient Selection*
  • Practice Guidelines as Topic / standards*