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lüll Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal Bax JJ; Ansalone G; Breithardt OA; Derumeaux G; Leclercq C; Schalij MJ; Sogaard P; St John Sutton M; Nihoyannopoulos PJ Am Coll Cardiol 2004[Jul]; 44 (1): 1-9Cardiac resynchronization therapy (CRT) has been proposed as an alternative treatment in patients with severe, drug-refractory heart failure. The clinical results are promising, and improvement in symptoms, exercise capacity, and systolic left ventricular (LV) function have been demonstrated after CRT, accompanied by a reduction in hospitalization and a superior survival as compared with optimized medical therapy alone. However, 20% to 30% of patients do not respond to CRT. Currently, patients are selected mainly on electrocardiogram criteria (wide QRS complex, left bundle branch block configuration). In view of the 20% to 30% of nonresponders, additional selection criteria are needed. Echocardiography (and, in particular, tissue Doppler imaging) may allow further identification of potential responders to CRT, based on assessment of inter- and intraventricular dyssynchrony. In addition, echocardiography may allow optimal LV lead positioning and follow-up after CRT. In the current review, the different echocardiographic approaches to predict response to CRT are discussed. In addition, the use of echocardiography to guide LV lead positioning and follow-up after CRT are addressed.|Clinical Trials as Topic[MESH]|Diagnostic Tests, Routine[MESH]|Echocardiography/*methods[MESH]|Heart Conduction System/*diagnostic imaging/*physiopathology[MESH]|Heart Failure/diagnostic imaging/physiopathology[MESH]|Heart Ventricles/diagnostic imaging/physiopathology[MESH]|Humans[MESH]|Myocardial Contraction/physiology[MESH]|Stroke Volume/physiology[MESH]|Ventricular Function, Left/physiology[MESH] |