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Review
. 2021 May;26(3):735-745.
doi: 10.1007/s10741-020-10040-2. Epub 2020 Oct 24.

Cardiac resynchronization therapy in heart failure patients: tough road but clear future

Ziyu Wang  1 , Yongquan Wu  2 , Junmeng Zhang  3
Affiliations
Review

Cardiac resynchronization therapy in heart failure patients: tough road but clear future

Ziyu Wang et al. Heart Fail Rev. 2021 May.

Erratum in

Abstract

Cardiac resynchronization therapy (CRT) based on biventricular pacing (BVP) is an invaluable intervention currently used in heart failure (HF) patients. The therapy involves electromechanical dyssynchrony, which can not only improve heart function and quality of life but also reduce hospitalization and mortality rates. However, approximately 30% to 40% of patients remain unresponsive to conventional BVP in clinical practice. In the recent years, extensive research has been employed to find a more physiological approach to cardiac resynchronization. The His-Purkinje system pacing (HPSP) including His bundle pacing (HBP) and left bundle branch area pacing (LBBaP) may potentially be the future of CRT. These technologies present various advantages including offering an almost real physiological pacing, less complicated procedures, and economic feasibility. Additionally, other methods, such as isolated left-ventricular pacing and multipoint pacing, may in the future be important but non-mainstream alternatives to CRT because currently, there is no strong evidence to support their effectiveness. This article reviews the current situation and latest progress in CRT, explores the existing technology, and highlights future prospects in the development of CRT.

Keywords: Cardiac resynchronization therapy; His bundle pacing; Isolated left-ventricular pacing; Left bundle branch area pacing; Multipoint pacing.

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