How to treat cardiac dyssynchrony in heart failure with reduced ejection fraction

Stefan Bogdan*, Alexandru Ababei, Michael Glikson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Cardiac resynchronization therapy (CRT) has become part of the standard of care for symptomatic patients with heart failure, reduced ejection fraction (HRrEF), and wide QRS, despite optimal medical therapy. Device technology, operator experience, and post-implant optimization on follow-up have significantly improved CRT response during the last decade. In parallel, conduction system pacing (CSP) has emerged as a new and potentially better tool for maintaining physiological ventricular activation in patients with antibradycardia pacing, as well as an alternative for dyssynchrony correction in HFrEF patients. The current review focuses on cardiac dyssynchrony pathophysiology and correction methods, clinical evidence on CRT and CSP as therapies for cardiac dyssynchrony, and the role of each according to clinical evidence and current guidelines for HFrEF treatment.

Original languageEnglish
JournalRevista Romana de Cardiologie
StateAccepted/In press - 2024
Externally publishedYes


  • cardiac resynchronization therapy
  • heart failure
  • LBBB
  • left bundle branch area pacing
  • reduced left ventricular ejection fraction


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