Acute Beneficial Hemodynamic Effects of a Novel 3D-Echocardiographic Optimization Protocol in Cardiac Resynchronization Therapy

Patient with ischemic cardiomyopathy, severly reduced systolic left ventricular (LV)-function (EF 16.8%), left bundle branch block and dyspnea on exertion (NYHA class III) selected for cardiac resynchronisation therapy (CRT) before biventricular pacemaker implantation: A) tracing of the LV endocardial boundary in the multiple apical and short axis views. From these datasets a volumetric model of the left ventricle is drawn (B), and time-volume curves are automatically integrated for each segment: C) time-volume curves of the patient before pacemaker implantation (upper panel); immediately after implantation (middle panel); after complete echocardiographic optimization (lower panel). Shown are the respective SDI values after each optimization step.