Evaluation of Left Ventricular Scar Burden on Outcome of Cardiac Resynchronization Therapy

Background: Scar burden assessment could help in tailoring better response to Cardiac Resynchronization Therapy (CRT).Methods: Thirty patients underwent CRT implantation. Pre-implantation Cardiac Magnetic Resonance (CMR) with late gadolinium enhancement technique to examine LV scar burden.Results: Thirty patients received CRT (mean age 58.7±9.0, 24 males). CRT implantation showed functional improvement in form of reverse LV remodeling ( ≥15%), which was documented in 19 patients. Applying ROC for predicting CRT non-response, showed a cutoff 36.5% for global LV scar burden had a sensitivity of 81.8% and specificity of 68.4%. a cutoff 4.5 segments with scar thickness ≥50% of whole segment thickness had a sensitivity of 81.8% and specificity of 63.2%. A cutoff 12% for lateral wall scar burden had a sensitivity of 81.8% and specificity of 68.4%.Conclusion: LV scar had unfavorable impact on CRT response. Both global and lateral wall scar burden, extent could predict CRT non-response status.