La resincronización cardiaca se ha consolidado en sus 10 años de vida como un tratamiento insustituible para determinados pacientes afectados de insuficiencia cardiaca refractaria. Este capítulo pretende transmitir algunos de los avances recientes y líneas de evolución que mantienen a este tipo de estimulación en permanente actualidad.
Se revisan seguidamente los parámetros fisiopatológicos que justifican la mejora en la calidad de vida, disminución de las necesidades de tratamiento hospitalario y supervivencia logrados mediante la estimulación biventricular.
También se aborda a los grupos de pacientes, fuera de las indicaciones establecidas en las guías de actuación internacionales, que son el centro de atención en importantes ensayos clínicos para ampliar la aplicación de esta terapia.
Para optimizar la respuesta a la resincronización es preciso también una correcta planificación del implante incluida una cuidada estrategia de seguimiento y optimización en la programación del estimulador.
Las indicaciones de resincronización se basan actual mente en determinados parámetros eléctricos y ecocar diográficos, se comentan también estos conceptos conespecial énfasis en algunos datos de imagen que presumiblemente permitirán en un futuro próximo precisar la selección de pacientes y mejorar el porcentaje de respuestas al tratamiento de estimulación.
Palabras clave
Insuficiencia cardiaca
Terapia de resincronización cardiaca
Ecocardiografía Doppler
Remodelado ventricular
Seguimiento
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