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Patients with heart failure who require an implantable defibrillator should have cardiac resynchronisation routinely

Department of Cardiology, Castle Hill Hospital, Hull Royal Infirmary and University of Hull, Kingston-upon-Hull, UK

Correspondence to:
Professor John G F Cleland, Department of Cardiology, University of Hull, Castle Hill Hospital, Kingston-upon-Hull, HU16 5JQ, UK; j.g.cleland@hull.ac.uk

The first 150 words of the full text of this article appear below.

Should patients with heart failure who require an implantable cardiac defibrillator (ICD) get a device capable of delivering cardiac resynchronisation therapy (CRT-D) routinely? For those that like to read the conclusions first, the answer is "yes". It is difficult to justify implanting only a defibrillator in anyone who has heart failure and an indication for an ICD. Most of these patients should get a CRT-D device.

This conclusion might seem odd at first but the arguments are quite straightforward. National Institute for Health and Clinical Excellence (NICE) guidelines¹ suggest that patients with heart failure as a result of ischaemic heart disease (IHD) should get an ICD if their left ventricular ejection fraction (LVEF) is <35% and they also have non-sustained ventricular tachycardia (NSVT) on ambulatory electrocardiographic monitoring and inducible ventricular tachycardia (VT) on electrophysiological monitoring, provided that the patient is not in end-stage heart failure and is not within one . . . [Full text of this article]