Cardiac Resynchronization Therapy

Congestive heart failure (CHF) continues to be a major source of morbidity, mortality, and health-care spending in today’s society. In the past 20 years, device-based therapies such as implantable cardioverter defibrillators (ICDs), cardiac resynchronization therapy (CRT), and left ventricular assist devices have been developed and demonstrated to improve outcomes in patients with CHF and systolic dysfunction. These therapies treat two of the major causes of death associated with CHF, namely sudden cardiac death and pump failure. This chapter focuses on the application of CRT for treatment of CHF, with a focus on the therapeutic mechanisms, historical development, evolution of the technologies, implant techniques and patient follow-ups, clinical trials, evolving indications, approaches for optimizing therapies, and future directions.