Kardiale Resynchronisationstherapie

Cardiac resynchronization therapy (CRT) is a new concept in the treatment of patients with drug-refractory heart failure (HI). Candidates for CRT are HI patients with NYHA class III-IV, left bundle branch block and QRS width ≥0.12 s. CRT leads to improvements in hemodynamics both acutely and during long-term follow-up, resulting in better cardiopulmonary exercise tolerance. In addition, patients receiving CRT have a better survival rate with or without implantable cardiac defibrillator (ICD) back-up. CRT is possible in patients with atrial fibrillation. CRT with ICD back-up is indicated in patients with HI, low left ventricular function (EF), indication for CRT and coronary artery disease, whereas this question is not fully resolved in patients with dilated cardiomyopathy. CRT patients must be followed up; home monitoring is a very promising approach for quick and safe surveillance of these patients.