title: [Resynchronization therapy of heart failure].
abstract: Heart failure has a high prevalence and it has a poor prognosis despite the advances in pharmacological treatment. Cardiac resynchronization therapy with biventricular pacemaker has a clinically proven efficacy in the treatment of heart failure with intraventricular dyssynchrony. Conventionally the therapy is indicated in severe drug refractory heart failure (NYHA III-IV) with optimal drug treatment, increased QRS duration (> or = 120 ms), echocardiographic parameters (left ventricular ejection fraction at most 35%). Implementation of new methods (tissue doppler echocardiography, CT, MRI, electroanatomical mapping) can help to select potentially responding patients. Individual optimization of therapy can be performed with non-invasive and invasive methods, the efficacy can be improved even in responding patients. Due to the outstanding efficiency widening the indications is a must. Currently, the efficacy is being investigated in mild heart failure and patients with narrow QRS. Several other questions (transvenous or surgical implantation, need of an implantable defibrillator) will be answered in future trials.
authors.affiliation: Semmelweis Egyetem Er- és Szívsebészeti Klinika.
authors.forename: Béla
authors.initials: B
authors.lastname: Merkely
authors.forename: Attila
authors.initials: A
authors.lastname: Róka
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Szilágyi
authors.forename: Endre
authors.initials: E
authors.lastname: Zima
authors.forename: Valentina
authors.initials: V
authors.lastname: Kutyifa
authors.forename: Astrid
authors.initials: A
authors.lastname: Apor
authors.forename: Gábor
authors.initials: G
authors.lastname: Szücs
authors.forename: László
authors.initials: L
authors.lastname: Gellér
mesh_terms: D002303:Cardiac Output, Low / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods / Q000639:trends; D017147:Defibrillators, Implantable; D006329:Heart Conduction System / Q000503:physiopathology*; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006339:Heart Rate; D006801:Humans; D010138:Pacemaker, Artificial; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000628:therapy