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Role of cardiovascular imaging in cardiac resynchronization therapy: a literature review

Sassone, Biagioa,b; Nucifora, Gaetanoc,d; Mele, Donatoe; Valzania, Cinziaf; Bisignani, Giovannig; Boriani, Giuseppehfor Task Force on Imaging of Italian Association of Arrhythmias and Cardiac Stimulation (AIAC)

Journal of Cardiovascular Medicine: May 2018 - Volume 19 - Issue 5 - p 211–222
doi: 10.2459/JCM.0000000000000635

Cardiac resynchronization therapy (CRT) is an established treatment in patients with symptomatic drug-refractory heart failure and broad QRS complex on the surface ECG. Despite the presence of either mechanical dyssynchrony or viable myocardium at the site where delivering left ventricular pacing being necessary conditions for a successful CRT, their direct assessment by techniques of cardiovascular imaging, though feasible, is not recommended in clinical practice by the current guidelines. Indeed, even though there is growing body of data providing evidence of the additional value of an image-based approach as compared with routine approach in improving response to CRT, these results should be confirmed in prospective and large multicentre trials before their impact on CRT guidelines is considered.

aDepartment of Cardiology, Annunziata Hospital

bDepartment of Cardiology, Delta Hospital, Azienda Unità Sanitaria Locale Ferrara, Ferrara, Italy

cCardiology Department, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK

dFlinders University, Adelaide, Australia

eNoninvasive Cardiology Unit, University Hospital of Ferrara, Ferrara

fInstitute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna

gDepartment of Cardiology, Castrovillari Hospital, Cosenza

hCardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico of Modena, Modena, Italy

Correspondence to Biagio Sassone, MD, FAIAC, Department of Cardiology, Annunziata Hospital, Azienda Unità Sanitaria Locale Ferrara, via Giovanni Vicini 2, Cento, 44042 Ferrara, Italy Tel: +39 51 6838219; fax: +39 51 6838119; e-mail:

Received 3 October, 2017

Revised 4 January, 2018

Accepted 23 January, 2018

© 2018 Italian Federation of Cardiology. All rights reserved.