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Quantitative Radionuclide Assessment of Cardiac Dyssynchrony: Breakthrough in Patient Selection for Cardiac Resynchronization Therapy for Refractory Heart Failure?

An estimated 5.7 million adults with heart failure (HF) currently burden the human, medical, and financial resources of the United States. By 2030, this number is expected to increase to more than 8 million. In 2012, the total cost of HF in the United States was estimated at $30.7 billion, which is expected to increase to $69.7 billion by 2030. HF contributes substantially to mortality and is documented on 1 in 9 death certificates in the United States (1). HF mortality 1 y after diagnosis appears to be declining in the 21st century according to Medicare data: 31.7% in 1999 to 29.6% in 2008 (2). These improvements have been attributed to evidence-based approaches in the management of HF, including guideline-directed medical therapy, coronary revascularization, implantable cardioverter defibrillators, and cardiac resynchronization therapy (CRT) in which both the right and the left ventricles are paced synchronously to augment cardiac output (1).