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Ventricular failure manifests in many forms, its underlying physiology ranging from overt left ventricular (LV) systolic dysfunction to isolated right ventricular (RV) diastolic dysfunction, and the wide portfolio of resulting symptoms vary from chronic fluid retention to acute multiorgan dysfunction and death.
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Left ventricular function correlates strongly with total and cardiovascular mortality (Curtis et al). Among patients with coronary heart disease , left ventricular function is actually a stronger predictor of death than the atherosclerotic burden.The simplest and cheapest tool is a fluid-filled pigtail catheter in the LV and an arterial sheath to determine either the best pacing site or the best AV-delay. It has to be emphasized that every pacing site is associated with an optimal AV-delay, thus an individualized protocol has to be run. Every patient has an individual superior pacing site.
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