Practical applicability of cardiac resynchronization therapy with automated hemodynamic optimization

█ Case Report

DOI: 10.26430/CHUNGARICA.2023.53.3.250

Authors:
Polgár Balázs, Bógyi Péter, Duray Gábor Zoltán
Észak-pesti Centrumkórház – Honvédkórház, Budapest

Levelezési cím:
Dr. Polgár Balázs, e-mail: balazspg@gmail.com

Summary
The beneficial effects of cardiac resynchronization therapy (CRT) are well known in reduced ejection fraction heart failure (HFrEF) patients with wide QRS complex, supported by large randomized clinical trials. However significant proportion of patients does not respond to therapy or even deteriorate due to that. CRT response corresponds to QRS width and morphology. Success rate is best in highly broad QRS complex (>150 ms) and left bundle branch block (LBBB) patients. Conversely intermedier width QRS (130-150 ms) and non-LBBB QRS morphology (atypical intraventricular conduction delay, right bundle branch block) have the highest non-resonderity rate. We present the case of a patient from the latter group who responded well also echocardiographically as well as clinically to the hemosensor driven CRT. In this patient population a CRT system with automated hemodynamic optimization might prove beneficial and replace systematic echocardiographic device optimization.

ISSUE: CARDIOLOGIA HUNGARICA | 2023 | VOLUME 53, ISSUE 3

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