Cardiac resynchronization therapy offers no benefit beyond implantable cardioverter defibrillator (ICD) therapy

The Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT) study showed CRT, a standard of care in heart failure patients with a wide QRS, is not beneficial in patients with heart failure and a narrow QRS complex, below 130 milliseconds (msec).
The results reaffirm current guidelines excluding patients with a narrow QRS for CRT, and expand the body of evidence that simple electrocardiographic determination of QRS duration remains the most important predictor of the clinical benefits of CRT, rather than measures of mechanical dyssynchrony by echocardiography. Based on the results of EchoCRT, the identification of patients who will obtain the benefit of CRT can be done most easily by a 12 lead-ECG.

‘Results from previous smaller trials had suggested a potential for CRT in heart failure patients with narrow QRS. EchoCRT now provides evidence from a definite outcome trial that patients with symptomatic heart failure with QRS width less than 130msec do not benefit from CRT,’ said co-lead investigator Frank Ruschitzka, MD, from the University Hospital in Zurich, Switzerland.
‘The EchoCRT trial evaluated an important question for daily clinical practice. The results will help to guide physicians