Heart rhythm : the official journal of the Heart Rhythm Society
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The aim of this article is to critically review the data accumulated to date on the application of cardiac resynchronization therapy (CRT) via biventricular pacing techniques to manage patients with advanced heart failure. The data from studies evaluating the effects of long-term right ventricular (RV) pacing are also briefly reviewed. ⋯ CRT offers hemodynamic and clinical improvement to patients with moderate-to-advanced heart failure, and it might significantly prolong survival in selected patients, particularly if devices with defibrillation backup are used. Further confirmatory data from randomized mortality trials are needed, and issues of cost efficacy must be resolved before this vital therapeutic alternative is ready for prime time therapy of heart failure patients.