CRT-P vs CRT-D Selection — EECC MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiac DevicesCRT-P vs CRT-D SelectionEECC

An asymptomatic 54-year-old has severe chronic aortic regurgitation, LVEF 57%, LV end-systolic diameter 52 mm and body-surface area 1.72 m². Serial measurements are reproducible. What is the preferred management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Aortic-valve surgery for asymptomatic adverse LV remodelling

The best answer is “Aortic-valve surgery for asymptomatic adverse LV remodelling”. An LV end-systolic diameter above 50 mm, and an indexed value above about 25 mm/m², indicates adverse LV remodelling and supports surgery in severe aortic regurgitation. “Continue annual surveillance until LVEF falls below 40%” is less appropriate because waiting for advanced systolic failure sacrifices postoperative recovery “Begin a loop diuretic and repeat imaging in two years” is less appropriate because diuresis does not correct progressive volume-overload remodelling “Offer transcatheter edge-to-edge mitral repair” is less appropriate because mitral edge-to-edge repair does not treat the aortic lesion “Use exercise restriction as the definitive treatment” is less appropriate because exercise restriction cannot prevent chronic regurgitant volume loading

Reference: 2025 ESC/EACTS Guidelines for valvular heart disease. https://academic.oup.com/eurheartj/article/46/44/4635/8234488