Cardiac resynchronization therapy is appropriate for all patients requiring chronic right ventricular pacing: the con...

There has been compelling evidence for the use of biventricular (BiV) pacing to reduce mortality and heart failure (HF) hospitalization in patients with HF symptoms, depressed ejection fraction (EF), and a broad QRS. Cardiac resynchronization therapy (CRT) provides benefit for patients with depressed EF and minimal HF symptoms. Although data from CRT trials are compelling, clinical evidence to recommend BiV pacing to all patients who require a high degree of right ventricular (RV) pacing are lacking. This article summarizes the relevant studies demonstrating that BiV pacing is not appropriate therapy for all patients who require chronic RV pacing.