Cardiac Resynchronization Therapy - Refocus on the Electrical Substrate

Marc Strik, Sylvain Ploux, Kevin Vernooy, Frits W. Prinzen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Cardiac resynchronization therapy (CRT) is an established treatment for selected heart failure patients with conduction disease. Many studies aimed at quantifying mechanical dyssynchrony in CRT candidates when it became apparent that 30-50% of CRT recipients showed no improvement after implantation. As these, often echocardiography-based, measurements have not yet succeeded in estimating the mechanical substrate in an accurate and reproducible manner, interest in electrical substrate has renewed. In this review, current knowledge concerning electrical substrate in CRT candidates will be explored and applied to current CRT practice, highlighting why the electrical substrate is both essential and sufficient for successful CRT. Finally, novel ways to better measure and treat the electrical substrate are discussed. (Circ J 2011; 75: 1297-1304)
Original languageEnglish
Pages (from-to)1297-1304
JournalCirculation Journal
Issue number6
Publication statusPublished - Jun 2011


  • Cardiac resynchronization therapy
  • Electrophysiology
  • Left bundle branch block

Cite this