Programmation optimale des stimulateurs multisites et suivi des patients après thérapie de resynchronisation cardiaque

While substantial progress has been made over the past decade in the medical treatment of heart failure, certain patients fail to respond to optimal treatment despite the availability of excellent drugs. Cardiac resynchronisation therapy, or multisite pacing, appears to offer great hope for certain patients with dilated cardiomyopathy of idiopathic or ischaemic origin with signs of cardiac dyssynchrony, usually in the form of a widened QRS complex on the surface ECG. This new therapy has been shown to produce definite beneficial effects on the symptoms of patients, improving the functional class and walking distance in particular, and also prolonging survival. The optimal programming of the multisite pacemaker is a crucial aspect of this new treatment and requires a meticulous approach, the practical implications of which are addressed in this article.