A Case Who Benefited From Cardiac Resynchronization Therapy

Cardiac resynchronization therapy is a novel non-pharmacological treatment approach in the treatment of heart failure. Previous studies proved the safety and efficacy of this treatment. The selection of the most suitable candidate for cardiac resynchronization therapy is a crucial issue and still a matter of debate. Variable clinical, electrocardiographic and echocardiographic criteria have been proposed for appropriately selecting candidates for this therapy. Unfortunately, we still do not have satisfactory selection criteria set, which determines patients who will mostly benefit from this therapy. In this case report, we present a 60-year-old woman with dilated cardiomyopathy, who underwent atriobiventricular pacemaker implantation for cardiac resynchronization therapy. This patient would presumebly benefit from this therapy due to long (180 ms) QRS duration, long (170 ms) PQ duration, long ( 380 ms) mitral regurgitation duration and reltively long (> 130 ms) septum-posterior wall motion delay. As expected, symptoms, functional class and exercise capacity improved dramatically after therapy and it is shown that this improvement is not a placebo effect. We discussed which patient will benefit mostly from cardiac resynchronization therapy. (Türk Kardiyol Dern Arş 2004; 32: 44-51)