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Abstract

Patients with heart failure and ventricular conduction disturbance benefit haemodynamically from cardiac resynchronization therapy (CRT), but reduced mortality with CRT has not been demonstrated. The implantable cardioverter-defibrillator (ICD) reduced sudden death, which accounts for more than 50% of heart failure mortality. This review focuses on data from trials on ICD and CRT treatment in heart failure patients. The design of one study — the Pacing in Cardiomyopathies, a European Study (PACMAN) — is presented. Current recruitment in this trial indicates that 30% of patients receiving CRT require ICD backup. Ongoing larger trials will determine the true benefit of ICD and CRT in heart failure patients.

Cardiac resynchronization therapy, heart failure, implantable defibrillator

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