Insights from implementing a routine Cardiac Resynchronization optimization clinic in a tertiary Belgian Hospital

Abstract

Value of a routine protocol-driven post-implant management cardiac resynchronization therapy clinic

Selected heart failure patients show conduction disturbances leading to so-called ventricular dyssynchrony, i.e. instead of beating simultaneously the two ventricles beat slightly out of phase. Cardiac resynchronization therapy (CRT) is a device-based intervention inspired by the technology utilized in pacemakers. Its main feature is that it's capable of pacing both heart chambers simultaneously, which improves heart function as well as relieves symptoms. However, up to one-third of patients seem non-responsive to CRT, despite correct implementation and programming of the device. To assess this issue, strenuous effort was taken to define a multidisciplinary protocol-driven approach for post-implant care, which served to evaluate ambulatory CRT patients who did not exhibit a positive response. Even though the achieved results in the non-responder's group were promising, this protocol