Biventricular pacing for congestive heart failure

Despite significant advancements in pharmacological therapy, mortality continues to remain high in patients with congestive heart failure (1). Much attention has been paid to optimization of pacing modalities for patients with left ventricular dysfunction when ventricular pacing is required. Patients with congestive heart failure frequently have symptomatic chronotropic incompetence, sinus node dysfunction, or atrioventricular block, all of which are class I indications for cardiac pacing (2). In addition, atrial fibrillation afflicts 10 to 30% of patients with congestive heart failure.