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Review
. 2024 Mar;35(Suppl 1):68-76.
doi: 10.1007/s00399-024-01004-2. Epub 2024 Feb 29.

[History of cardiac resynchronization therapy : 30 years of electrotherapeutic management for heart failure]

[Article in German]
Christoph Stellbrink  1
Affiliations
Review

[History of cardiac resynchronization therapy : 30 years of electrotherapeutic management for heart failure]

[Article in German]
Christoph Stellbrink. Herzschrittmacherther Elektrophysiol. 2024 Mar.

Abstract
in English, German

The first permanent biventricular pacing system was implanted more than 30 years ago. In this article, the historical development of cardiac resynchronization therapy (CRT), starting with the pathophysiological concept, followed by the initial "proof of concept" studies and finally the large prospective-randomized studies that led to the implementation of CRT in heart failure guidelines, is outlined. Since the establishment of CRT, both an expansion of indications, e.g., for patients with mild heart failure and atrial fibrillation, but also the return to patients with broad QRS complex and left bundle branch block who benefit most of CRT has evolved. New techniques such as conduction system pacing will have major influence on pacemaker therapy in heart failure, both as an alternative or adjunct to CRT.

Vor mehr als 30 Jahren erfolgte die erste Implantation eines permanenten, biventrikulären Herzschrittmachersystems bei einem Patienten mit Herzinsuffizienz und ventrikulärer Leitungsstörung. In diesem Artikel soll die historische Entwicklung der kardialen Resynchronisationstherapie (CRT) vom pathophysiologischen Konzept über die ersten Proof of concept-Studien bis hin zu den großen randomisierten Studien, die dann zum Einzug der CRT in die Leitlinien zur Behandlung der Herzinsuffizienz geführt haben, dargestellt werden. Auch nach der Etablierung der CRT kam es zum einen zu einer Ausweitung der Indikationen z. B. auf Patienten mit milder Herzinsuffizienz oder Vorhofflimmern, aber auch zur Rückbesinnung auf die Patienten mit breiterem QRS-Komplex und Linksschenkelblock, die am meisten profitieren. Neue Techniken wie das Conduction-System-Pacing werden die Schrittmachertherapie bei Herzinsuffizienz verändern, als Alternative oder Ergänzung zur CRT.

Keywords: Cardiac resynchronization therapy; Conduction System Pacing; Heart failure; Left bundle branch block; Pacemaker.

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