AI Insight
Cardiac resynchronisation therapy with biventricular pacing (BiV-CRT) has transformed heart failure treatment for patients with left bundle-branch block over the past 30 years. The therapy evolved from observations that left bundle-branch block causes cardiac impairment to the development of a technique combining leads in both the left ventricular free wall and right ventricle, which produces significant improvements in acute cardiac function. The introduction of specialized leads enabled a fully transvenous approach, with the left ventricular lead placed through a branch of the coronary sinus.
Why it matters
This therapeutic advancement provides an effective treatment option for heart failure patients with specific conduction abnormalities, improving cardiac function and quality of life. The minimally invasive transvenous approach makes the procedure accessible to a broader patient population compared to more invasive surgical alternatives.
Understand the Science
Cardiac resynchronisation therapy with biventricular pacing (BiV-CRT) revolutionised the treatment of heart failure in patients with left bundle-branch block (LBBB). Its development, founded upon observations that LBBB leads to cardiac impairment,1 progressed to finding that combining a lead implanted on the left ventricular free wall with a lead in the right ventricle could provide drastic improvements in acute cardiac function in patients with LBBB.2 The development of dedicated leads facilitated the fully transvenous approach to BiV-CRT, with the left ventricular free wall targeted by using a ventricular branch of the coronary sinus.
Source: [Comment] Cardiac resynchronisation therapy: 30 years of progress