Document Detail

Echocardiography-guided biventricular pacemaker optimization: role of echo Doppler in hemodynamic assessment and improvement.
MedLine Citation:
PMID:  22908920     Owner:  NLM     Status:  In-Data-Review    
In spite of improvements in heart failure management and increasing utilization of cardiac resynchronization therapy (CRT), approximately 30-40% of CRT patients remain nonresponders and 50% or more are echocardiographic nonresponders (defined as less than 15% reduction in left ventricular end systolic volume post-CRT). Optimization guided by echocardiography has been studied as one of the methods to improve the nonresponder rate to CRT. Echo-guided biventricular (Biv) pacemaker optimization has been associated with improvement in acute cardiac hemodynamics and improvement in functional class. In this review, the authors discuss various methods to optimize Biv pacemaker by echocardiography, recent advances in pacemaker optimization and the limitations of echocardiography. The authors also demonstrate complex hemodynamic derangements in heart failure via multiple case examples highlighting the role of comprehensive echo Doppler in elucidating cardiac hemodynamics encountered in CRT nonresponders, as well as tailoring of Biv pacemaker optimization to the underlying physiologic derangement.
Reza Rafie; Tasneem Z Naqvi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  10     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-08-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  859-74     Citation Subset:  IM    
Echocardiographic Laboratories, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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