Ventricular resynchronization: a promising therapy for heart failure

Primarily a disease of the elderly, heart failure continues to be an ever-increasing health care problem given the growth in the number of individuals over age 65. Although there have been many advances in the pharmacologic management of heart failure, there continues to be a significant number of patients with persistent symptoms despite maximal therapy and it is likely that this group of patients will only continue to increase in number. Given this, significant research has gone into exploring new modalities, such as device therapies, to treat heart failure. Of these, ventricular resynchronization has emerged as one of the most promising. This review will examine the most important aspects of ventricular resynchronization therapy including: the significance of ventricular dyssynchrony, the role of traditional pacemakers, the effects on contractile function and reverse remodeling, and the currently accepted indications for resynchronization devices. Additionally, various aspects of completed and ongoing trials will be discussed.