부산대학교 도서관

This review article discusses the role of resynchronization therapy pacing in the treatment of drug-refractory heart failure. The pathophysiological mechanisms underlying heart failure are first examined including the mechanical and electrical implications of a decrement in the cardiac contractile state. Next, the concept of atrial synchronized biventricular pacing and its effect of maintaining ventricular activation sequences near normalcy are discussed. Clinical evidence is cited concerning the hemodynamic improvement achieved by this mode of pacing. The placement of a lead to attain optimal left ventricular stimulation remains a challenging process and is still evolving as new pacemaker lead designs are being formulated. Overall, biventricular pacing seems to be a promising adjuvant treatment modality for severe heart failure; its true impact will become manifest as more patients receive resynchronization therapy. [ABSTRACT FROM AUTHOR]