Cardiac Resynchronization Therapy (CRT)-Narrow-dp/Dt-Study

CRT in Patients With Narrow QRS, Echodesynchronisation and LV dp/Dt-Response With Pressure Wire

Goal is to examine the efficy of Cardiac Resynchronization Therapy in heart failure patients with narrow QRS complex and optimized medical treatment but echocardiographic desynchronization detection as well as the positve increase of the intraoperative pressureincreasespeed in reverse remodelling and a secondary improvement of functional parameters

Inclusion Criteria:

• EF < 35%
• CHD or dilate cardiomyopathy
• sinus rhythm
• NYHA III (or IV but stable recompenstated)
• QRS < 120 ms 2-3 of the following:
• LV-fillingtime < 40% of the cyclelength
• TDI septal-lateral (LV basal) > 60ms
• 2D-Strain-Score > 9 points

Exclusion Criteria:

• tricuspid or artificial valve
• AV block II or III or PQ time > 250ms
• revasculisation or condition after cardiac surgery < 3 months
• myocardial infarction or bypass OP < 3 months
• hytertrphic obstructive cardiomyopathy, constrictive pericarditis
• intravenous catecholamines because of HF
• manifeste hyperthyreoses
• kidney failure (creatine >2,5 mg/dl)
• no written informed consent
• no compliance
• participation in another study
• life expectancy < 1 year
• patients < 18 years
• pragnancy or no safe contraception