Cardiac Resynchronization Therapy: Maximizing the Response to Biventricular Pacing.

Cardiac resynchronization therapy (CRT) has become a mainstay therapy to improve clinical outcomes of patients with left ventricular systolic dysfunction and a wide QRS complex, in addition to guideline-directed medical therapy. As clinical experience with CRT continues to expand, the device and lead design, along with implantation techniques, have evolved as well. However, there is a significant proportion of patients with heart failure who do not have a favorable response to CRT. In this review article, we will discuss how to maximize the response to CRT, which includes patient characteristics, device features, positioning of the lead, and device programming. We will also discuss the ongoing efforts to improve CRT.