IMR Press / RCM / Volume 10 / Issue 1 / pii/1560997099700-413445048

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
Implementing Cardiac Resynchronization Therapy in Routine Clinical Practice: Preoperative Considerations and Implantation Techniques
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1 St. Adolfstift Medical Clinic, Reinbek, Germany
2020 The Thorax Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
Rev. Cardiovasc. Med. 2009, 10(1), 29–37;
Published: 30 March 2009
Cardiac resynchronization therapy (CRT) using coronary sinus (CS) leads is an established therapy for congestive heart failure in patients with asynchronous ventricular contractions. CRT improves not only exercise tolerance but also the patient’s prognosis. Appropriate patient selection for CRT is essential for a successful therapeutic response. Inclusion criteria are based on symptoms (New York Heart Association classes III and IV), a reduced ejection fraction, and a widened QRS complex. The presence of objective markers of heart failure can be considered a prerequisite for successful CRT. CRT procedures are much longer than regular pacemaker implantations, and thus the risk of infection may be greater. Successful therapy depends on the placement of left ventricular leads, usually via the CS, which is a technically more challenging procedure than regular pacemaker implantations. Complications specific to CRT include ventricular arrhythmia, such as ventricular tachycardia or ventricular fibrillation; total atrioventricular block or sinus arrest without any escape rhythm; and CS dissection.
Cardiac resynchronization therapy
Coronary sinus leads
Congestive heart failure
Left ventricular leads
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