[Permanent cardiostimulation in the treatment of heart failure]

Congestive heart failure is a major health problem reaching epidemic proportions in the industrialized world. Despite significant advances in medical therapy, prognosis still remains dim. Cardiac resynchronization therapy is a novel therapeutic approach in management of heart failure patients. Its goal is the restoration of an impaired cardiac synchrony, which can be found in high number of heart failure patients. Cardiac dyssynchrony is characterized by presence of intra and interventricular conduction delays. Cardiac synchrony can be regained by biventricular stimulation. The procedure consists of a special lead being inserted via coronary sinus to a suitable branch of cardiac veins of the left ventricle in addition to a lead in the right ventricle cavity and right atrium. Several clinical trials have demonstrated that cardiac resynchronization therapy improves functional status and quality of life in majority of patients, as well as renders a favourable impact on prognosis.