Tissue Doppler echocardiography and biventricular pacing in heart failure: Patient selection, procedural guidance, follow-up, quantification of success

Fabian Knebel¹ , Rona Katharina Reibis² , Hans-Jürgen Bondke¹ , Joachim Witte¹ , Torsten Walde¹ , Stephan Eddicks¹ , Gert Baumann¹ and Adrian Constantin Borges¹

¹Charité Campus Mitte – University Medicine Berlin, Medical Clinic for Cardiology, Angiology, Pneumology, 10098 Berlin, Germany

²Klinik am See, Department of Cardiology, Rehabilitation Center of Cardiovascular Diseases, Seebad 84, 15562 Rüdersdorf (Berlin), Germany

author email corresponding author email

Cardiovascular Ultrasound 2004, 2:17doi:10.1186/1476-7120-2-17


Published:	15 September 2004

Abstract

Asynchronous myocardial contraction in heart failure is associated with poor prognosis. Resynchronization can be achieved by biventricular pacing (BVP), which leads to clinical improvement and reverse remodeling. However, there is a substantial subset of patients with wide QRS complexes in the electrocardiogram that does not improve despite BVP. QRS width does not predict benefit of BVP and only correlates weakly with echocardiographically determined myocardial asynchrony. Determination of asynchrony by Tissue Doppler echocardiography seems to be the best predictor for improvement after BVP, although no consensus on the optimal method to assess asynchrony has been achieved yet. Our own preliminary results show the usefulness of Tissue Doppler Imaging and Tissue Synchronization Imaging to document acute and sustained improvement after BVP. To date, all studies evaluating Tissue Doppler in BVP were performed retrospectively and no prospective studies with patient selection for BVP according to echocardiographic criteria of asynchrony were published yet. We believe that these new echocardiographic tools will help to prospectively select patients for BVP, help to guide implantation and to optimize device programming.