Prediction of superresponders to CRT

Prediction of superresponders to CRT

Prediction of superresponders to CRT: Various types of responses are possible after implantation of a cardiac resynchronization device (CRT) in a person with heart failure. There could be no response (non-responder), good response (responder), and a super response (superresponder). Some could even have a negative response.

Superresponders have a good clinical outcome. Those with wide QRS complex indicating extensive intraventricular conduction disease are likely to have a superresponse. They typically have a QRS duration of 150 milliseconds or more and left bundle branch block. Females and those with no previous infarction are likely to have a better response. Body mass index less than 30 kilograms per square meter and small baseline left atrial volume index may also predict a better response [1].

As an example, the authors presented a 55 year old female who had been implanted CRT with defibrillator 6 years earlier for non ischemic dilated cardiomyopathy. He left ventricular ejection fraction prior to implantation was 28%. It increased to 38% with CRT. Her left ventricular end diastolic volume index came down from 144 mL/m² to 95 mL/m² and her left ventricular end systolic volume index came down from 104 mL/m² to 59 mL/m².

Reference

1. Jan Steffel, Frank Ruschitzka. Superresponse to Cardiac Resynchronization Therapy. Circulation. 2014 Jul 1;130(1):87-90.