Heart failure with arrhythmia doctors recommend

6. Cardiac resynchronization therapy and heart failure patients

(1) The patients with the strongest evidences of CRT benefit included: QRS duration> 130ms, QRS wave with LBBB (I, A), or QRS interval> 150ms, QRS wave without LBBB (IIa, A) While LVEF <30%, the body function in good condition, the expected survival time of more than 1 year. Recently, based on the latest study, indications have been expanded to include patients with grade II cardiac function. (2) patients with persistent atrial fibrillation, NYHA III-IV grade, QRS interval> 120ms and LVEF <35%, the body function in good condition, the expected survival time of more than 1 year, can be considered CRT or CRTD installed to reduce The risk of HF worsening if:

• Patients with pacing require slow ventricular pacemaker because of their own treatment
• Dependence of pacemaker therapy in patients with atrioventricular node ablation
• patients with resting heart rate
• NYHA Class III-IV with LVEF <35%, regardless of QRS duration, to reduce the risk of HF deterioration – NYHA Class II, LVEF <35%, to reduce the risk of HF deterioration.

In summary, the clinical management of HF requires consideration of the high risk of arrhythmias in these patients. Fundamental structural heart disease limits the use of antiarrhythmic drugs in symptomatic patients. The treatment of implantable cardioverter defibrillator can effectively reduce the mortality of patients with LVEF. Only a small number of implants experienced a clinically relevant VA, and a primary prevention risk assessment was warranted for further study, including HFpEF risk stratification.