17th European Heart Disease and Heart Failure Congress
Policlinico San Matteo IRCCS, Italy
Title: Adaptive-ness and effective-ness: The two primary goals to achieve in CRT
Biography: Barbara Petracci
Cardiac Resynchronization Therapy (CRT) is known as a highly effective therapy in advanced heart failure patients with cardiac dissinchrony. However, still one third of patients do not fully respond to CRT. Among the many contributors for the high rate of non-responders, the lack of procedures dedicated to CRT device settings optimization is known as one of the most frequent. On the other side, the echocardiography optimization is not widely used in the real world of CRT follow up visits. Thus, device-based techniques have been developed to by-pass the need of repeated echo evaluations to optimize CRT settings. There are multiple drivers of non-response. Common factors are AV/VV timing, reduced BiV pacing, LV lead placement, presence of arrhythmias, appropriate patient selection, patient compliance and presence of comorbidities. The current challenge facing practitioners is to maximize the rate of patients who respond to CRT and the magnitude of the response. A very particular and important subgroup of HF population with CRT includes the patients with AF since the optimal use of CRT in this cluster remains uncertain. The current area of interest achieving these goals includes the tailoring patients’ selection, the individualizing LV placement and, in particular, the application of new technologies and algorithms for CRT delivery in optimal fashion, reducing inappropriate shocks incidence and optimizing device longevity.