Cardiac resynchronization therapy in acute and chronic heart failure syndromes

Abstract

Despite recent advances in drug treatment, congestive heart failure (CHF) remains a major health care issue associated with a poor quality of life and a severe prognosis. In the last decade, cardiac resynchronization therapy (CRT) has been assessed as a new therapy option in patients with severe left ventricular (LV) dysfunction. Hence, CRT has become a challenging and an efficient treatment in patients in New York Heart Association (NYHA) class III or IV with a left ventricular ejection fraction (LVEF) of less than 35%, wide QRS, or echocardiographic ventricular dyssynchrony. 1-6 Recently, CRT has demonstrated a significant reduction in both overall and cardiac mortality and great improvement in various functional parameters.6 It is now a validated treatment for severe CHF patients in NYHA class III or IV despite an optimal medical therapy. This chapter summarizes the history of CRT since preliminary reports have been published, and addresses a challenging question about the usefulness of CRT in unstable overt CHF patients. © 2008 Springer-Verlag London.