Routine assessment of dyssynchrony with present echo techniques is not recommended to guide the prescription of CRT (Recommendation Strong, Quality Low).

Values and Preferences This recommendation takes into account the quality of the evidence and the results of larger, multicentre studies.

Practical Tip Issues of reproducibility and inter- and intra-rater assessment identified in the larger studies limit the routine role of echo to guide the prescription of CRT. Ongoing imaging research (eg, scar, viability) is presently under investigation.