Based on recently available clinical experiences and criteria, one third of heart failure patients prove to be non-responder despite cardiac resynchronization therapy (CRT) and lack improvement in their clinical status despite optimal treatment. This fact leaded to a new research direction to find a parameter measured by a non-invasive imaging method (for instance echocardiography), which is able to evaluate left ventricular dyssynchrony and to select patients capable for CRT. The aim of this review is to demonstrate the possible role of the newest echocardiography method, the real-time three-dimensional echocardiography based on the available literature.