Cardiac resynchronisation – a new standard in heart failure therapy

Abstract

Chronic heart failure is a clinical syndrome and the final common pathway of different cardiac diseases. A rising incidence is reported all over the world, leading to enormous cost and spending of health care resources. Although medical therapy with beta blockers, ACE-inhibitors and spironolactone has proved to be efficacious, mortality remains high. Therefore the introduction of supplemental methods is very welcome and indeed, electrical therapies with implanted devices become increasingly important in this regard. Besides the implanted cardioverter defibrillator (ICD), cardiac resynchronisation therapy (CRT) has recently been shown not only to improve exercise tolerance, but also to prolong survival in patients with heart failure and cardiac asynchrony. Therefore, an overview of cardiac resynchronisation therapy, including additional CRT-ICD capabilities, is given herein according the literature. This includes current guidelines, our own implantation experience, and follow-up data of 500 patients during 1999 – 2007.