Initial Experience of Biventricular Pacing in Patients with Chronic Severe Heart Failure

T he number of patients with chronic heart failure has increased substantially during the last few decades. The use of drugs such as the converting enzyme inhibitors, angiotensin II receptor blockers, ‚-blockers and spironolactone has led to significant reduction of the mortality and morbidity associated with this disabling syndrome. Despite this, the prognosis of patients with drug-resistant heart failure remains disappointing. The first attempts of pacing these patients date from the early years of the previous decade. Atrioventricular pacing in various positions of the right ventricle was initially attempted, but results regarding its effectiveness were conflicting. A number of acute studies assessing the potential of biventricular pacing in patients with heart failure and intraventricular conduction disturbances in improving certain indexes of left ventricular performance has shown promising results. These findings have gained clinical importance after the achievement of permanent transvenous left ventricular pacing through branches of the coronary sinus. Following this, a number of chronic studies showed the beneficial influence of chronic biventricular pacing on chronic, Initial Experience of Biventricular Pacing in Patients with Chronic Severe Heart Failure