Dyssynchronous Heart Failure: A Clinical Review.

Authors :: Dikdan, Sean J.
Co, Michael Lawrenz
Pavri, Behzad B.
Source :: Current Cardiology Reports; Dec2022, Vol. 24 Issue 12, p1957-1972, 16p
Publication Year :: 2022
Abstract: Purpose of the Review: Dyssynchrony occurs when portions of the cardiac chambers contract in an uncoordinated fashion. Ventricular dyssynchrony primarily impacts the left ventricle and may result in heart failure. This entity is recognized as a major contributor to the development and progression of heart failure. A hallmark of dyssynchronous heart failure (HF<subscript>d</subscript>) is left ventricular recovery after dyssynchrony is corrected. This review discusses the current understanding of pathophysiology of HF<subscript>d</subscript> and provides clinical examples and current techniques for treatment. Recent Findings: Data show that HF<subscript>d</subscript> responds poorly to medical therapy. Cardiac resynchronization therapy (CRT) in the form of conventional biventricular pacing (BVP) is of proven benefit in HF<subscript>d</subscript>, but is limited by a significant non-responder rate. Recently, conduction system pacing (His bundle or left bundle branch area pacing) has also shown promise in correcting HF<subscript>d</subscript>. Summary: HF<subscript>d</subscript> should be recognized as a distinct etiology of heart failure; HF<subscript>d</subscript> responds best to CRT. [ABSTRACT FROM AUTHOR]