La resincronización cardíaca mediante estimulación biventricular se está consolidando como una opción terapéutica válida en determinados pacientes con insuficiencia cardíaca refractaria. Por otra parte, de manera simultánea estamos conociendo nuevas indicaciones para la utilización de desfibriladores intracavitarios, incluso con el único marcador de riesgo de una severa depresión de la contractilidad ventricular izquierda.
En la actualidad se están realizando algunos estudios que nos proporcionarán en pocos años información válida para decidir a qué pacientes, con indicación de estimulación biventricular o de desfibrilador implantables, debemos tartar mediante un sistema de desfibrilador resincronizador.
Revisaremos a continuación estos supuestos con el objetivo de proponer unas opciones clínicas que nos permitan evaluar en qué pacientes con indicación de resincronización cardíaca sería conveniente implantar un sistema aislado o con desfibrilador y a qué pacientes con indicaciones de desfibrilador implantable deberíamos tratar con un sistema suplementario de estimulación biventricular.
Palabras clave
Insuficiencia cardíaca
Resincronización cardíaca
Desfibrilador
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2005. Sociedad Española de Cardiología