Biventricular Pacemakes and Defibrillators
St. Paul Heart Clinic is aggressive in the use of cardiac resynchronization therapy (CRT) for the treatment of congestive heart failure (CHF). Classic indications target patients with functional class III to IV CHF and QRS duration greater than 120 ms. Expanded indications include patients with CHF and dyssynchrony on tissue Doppler imaging.
Patients with nonischemic cardiomyopathy and pacing-induced cardiomyopathy often have significant improvements in ejection fraction after CRT. Biventricular pacemakers have been used in some patients with moderate left ventricular dysfunction to improve systolic performance and avoid or delay ICD implantation. | 