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Cardiac resynchronization therapy in asymptomatic and mildly symptomatic chronic systolic heart failure: a new era of systolic heart failure management?

The incidence and prevalence of heart failure syndrome continue to increase, and it therefore remains a significant health problem in developed western countries. It is accompanied by high morbidity and mortality, and significantly affects the burden on health care system as well as the patients’ quality of life. Cardiac resynchronization therapy (CRT) with biventricular stimulation has recently emerged as an adjunctive treatment modality in patients with chronic systolic heart failure and documented electrical and mechanical dyssynchrony. Electrical dyssynchrony may be expressed as atrioventricular, interventricular or intraventricular asynchrony. The latter is associated with the