Gabriela Kaliská, Pavel Kmeč, Peter Margitfalvi
The review article presents the importance of dyssynchrony for the development of chronic heart failure and effects of cardiac resynchronization therapy. This therapy is indicated for patients with persistent symptoms of heart failure in spite of optimal medical therapy (NYHA III-IV class), reported left ventricular systolic dysfunction (left ventricular end-systolic diameter > 55 mm, LVEF < 35 %), and signs of inter-ventricular and intra-ventricular dyssynchrony (left bundle branch block, width QRS > 150 ms, echocardiographic signs of dyssynchrony). Beneficial effects on mortality left ventricular function, quality of life and exercise capacity is evident in 70 % patients. Indications for cardiac resynchronization and selection of positively responding patients have been currently under research. Timing of left ventricular and right ventricular stimulation is fundamental to get maximum haemodynamic benefit in the long-term course.