Cardiac magnetic resonance in cardiac resynchronization therapy: How useful it can be?

Abstract

Patients with heart failure, reduced ejection fraction, and signs of myocardial dyssynchrony have a poor prognosis. Cardiac resynchronization therapy is a proven therapeutic modality that reduces symptoms of heart failure as well as morbidity and mortality in these patients. Better identification of patients who could benefit from cardiac resynchronization therapy is an important factor because a significant percentage of patients do not experience clinical improvement after CRT implantation. Cardiac magnetic resonance is a useful, non-invasive, sophisticated diagnostic tool that can provide useful information on the aetiology of heart failure and the severity of mechanical dyssynchrony of the left ventricle. It helps evaluate the myocardial scar burden, which can predict a possible unsatisfactory response to therapy and helps improve clinical outcomes by enabling optimal positioning of the LV lead. Cardiac magnetic resonance in patient follow up after CRT implantation is proven to have significant clinical value. Conclusion: Cardiac magnetic resonance is a non-invasive imaging modality that can provide better identification of the patients who could respond well to cardiac resynchronization therapy. By providing valuable information about the severity of mechanical dyssynchrony, the myocardial scar burden and optimal positioning of the LV lead, it is useful in improving clinical outcomes after CRT implantation.

Keywords

• cardiac magnetic resonance
• cardiac resynchronization therapy
• heart failure
• mechanical dyssynchrony
• myocardial scar burden