title: Narrow QRS systolic heart failure: is there a target for cardiac resynchronization?
abstract: Cardiac resynchronization therapy has revolutionized the management of systolic heart failure in patients with prolonged QRS during the past 20 years. Initially, the use of this treatment in patients with shorter QRS durations showed promising results, which have since been opposed by larger randomized controlled trials. Despite this, some questions remain, such as, whether correction of mechanical dyssynchrony is the therapeutic target by which biventricular pacing may confer benefit in this group, or are there other mechanisms that need consideration? In addition, novel techniques of cardiac resynchronization therapy delivery such as endocardial and multisite pacing may reduce potential detrimental effects of biventricular pacing, thereby improving the benefit/harm balance of this therapy in some patients.
authors.affiliation: Department of Cardiovascular Imaging, 4th Floor Lambeth Wing, St Thomas' Hospital, London, SE1 7EH, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Jackson
authors.forename: Simon
authors.initials: S
authors.lastname: Claridge
authors.forename: Jonathan
authors.initials: J
authors.lastname: Behar
authors.forename: Eva
authors.initials: E
authors.lastname: Sammut
authors.forename: Jessica
authors.initials: J
authors.lastname: Webb
authors.forename: Gerald
authors.initials: G
authors.lastname: Carr-White
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.forename: Christopher Aldo
authors.initials: CA
authors.lastname: Rinaldi
mesh_terms: D058406:Cardiac Resynchronization Therapy; D004562:Electrocardiography; D054143:Heart Failure, Systolic / Q000628:therapy*; D006801:Humans; D018754:Ventricular Dysfunction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy
keywords: biventricular pacing; cardiac resynchronization therapy; dyssynchrony; heart failure; narrow QRS