Pre- and Intra-procedural Predictors of Reverse Remodeling After CRT
MRI-defined intra-LV dyssynchrony and myocardial scar extent are independent predictors of RR at 6 months after CRT. Electrical dyssynchrony as assessed by measuring QRS duration on surface ECG is a less powerful response predictor than mechanical dyssynchrony, mainly because of scar-related moderate QRS enlargements that do not translate into significant mechanical dyssynchrony in the viable myocardium. The presence of scar at pacing site, even when nontransmural, is associated to a lesser RR after CRT, whereas the mechanical delay at this site does not seem to influence the response.
Conclusion
MRI-defined intra-LV dyssynchrony and myocardial scar extent are independent predictors of RR at 6 months after CRT. Electrical dyssynchrony as assessed by measuring QRS duration on surface ECG is a less powerful response predictor than mechanical dyssynchrony, mainly because of scar-related moderate QRS enlargements that do not translate into significant mechanical dyssynchrony in the viable myocardium. The presence of scar at pacing site, even when nontransmural, is associated to a lesser RR after CRT, whereas the mechanical delay at this site does not seem to influence the response.
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