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Dyssynchronous Heart Failure: A Clinical Review

  • Heart Failure (HJ Eisen, Section Editor)
  • Published:
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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 (HFd) is left ventricular recovery after dyssynchrony is corrected. This review discusses the current understanding of pathophysiology of HFd and provides clinical examples and current techniques for treatment.

Recent Findings

Data show that HFd responds poorly to medical therapy. Cardiac resynchronization therapy (CRT) in the form of conventional biventricular pacing (BVP) is of proven benefit in HFd, 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 HFd.

Summary

HFd should be recognized as a distinct etiology of heart failure; HFd responds best to CRT.

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    Sean J. Dikdan, Michael Lawrenz Co & Behzad B. Pavri

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Sean J Dikdan has nothing to disclose. Michael Lawrenz Co reports travel support to HRS 2022 from Biotronik. Behzad B. Pavri reports they are a consultant for Medtronic; also Medtronic annually provides financial support towards the EP fellowship program at TJUH.

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Dikdan, S.J., Co, M.L. & Pavri, B.B. Dyssynchronous Heart Failure: A Clinical Review. Curr Cardiol Rep 24, 1957–1972 (2022). https://doi.org/10.1007/s11886-022-01797-z

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