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Kardiologie up2date 2010; 6(3): 229-245
DOI: 10.1055/s-0030-1255744
Diagnostische Verfahren und Bildgebung

© Georg Thieme Verlag KG Stuttgart · New York

Nicht invasive Bildgebung vor kardialer Resynchronisationstherapie

Ole-A.  Breithardt, Michael  Schmid, Dieter  Ropers
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Publication Date:
21 September 2010 (online)

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Abstract

The indication for cardiac resynchronisation therapy (CRT) with biventricular pacing for the treatment of advanced systolic heart failure is well established. The underlying principle is to resynchronize the dyssynchronous mechanical myocardial contraction patterns in patients with delayed electrical conduction, identified by a prolonged QRS complex in the 12-lead electrocardiogram (ECG). However, the correlation between QRS width and mechanical dyssynchrony is limited, in particular in cases with only moderate QRS prolongation of less than 150 ms. Cardiac imaging techniques such as echocardiography, magnetic resonance imaging (MRI) and cardiac CT allow better to identify the presence and extent of mechanical dyssynchrony and may thus help to overcome the limitations of the ECG. Furthermore these techniques may add important information about the amount of recruitable (viable) myocardium and on concomitant valvular diseases. This review article discusses the role of cardiac imaging before CRT implantation, with particular focus on echocardiography for the assessment of mechanical dyssynchrony and the role of cardiac MRI and CT for the assessment of myocardial viability and coronary artery disease.

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Priv.-Doz. Dr. med. Ole-A. Breithardt

Medizinische Klinik 2
Universitätsklinikum Erlangen

Ulmenweg 18
91054 Erlangen

Email: ole.breithardt@uk-erlangen.de

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