When is cardiac resynchronization therapy (biventricular pacing) indicated in the treatment of dilated cardiomyopathy?

Updated: Mar 02, 2021
  • Author: Vinh Q Nguyen, MD, FACC; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
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Current indications for class I cardiac resynchronization therapy based on the 2013 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) heart failure guidelines are as follows [13] :

  • NYHA class I symptoms persisting longer than 40 days following myocardial infarction [MI], left ventricular ejection fraction (LVEF) at or below 30%, sinus rhythm, left ventricular bundle-branch block (LBBB) with a QRS of 150 ms or longer (Multicenter Automatic Defibrillator Implantation Trial-cardiac-resynchronization therapy [MADIT-CRT] [133] )

  • NYHA class II or greater symptoms while on guideline-directed medical therapy (GDMT), with symptoms persisting longer than 40 days post MI, LVEF of 35% or below, sinus rhythm, LBBB with QRS of 150 ms or longer

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