cardiac resynchronization therapy

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• heart failure
  • Selected patients can undergo cardiac resynchronization therapy to reduce mortality.

In selected patients, cardiac resynchronization therapy with simultaneous pacing of the right and left ventricles (biventricular pacing) has been shown to improve exercise tolerance and NYHA functional class, and reduce the rate of recurrent hospitalization and overall mortality.

Current guidelines recommend biventricular pacing devices for patients in sinus rhythm who meet all of the following criteria:

• LV ejection fraction <35% s II, III, or IV heart failure symptoms (essentially the presence of any symptoms)
• Left bundle branch block with QRS duration >150 msec.

These patients also often meet criteria for an implantable cardioverter-defibrillator (ICD) to prevent sudden cardiac death and can undergo combination ICD and biventricular