Cardiac resynchronisation therapy with biventricular pacing (BiV-CRT) revolutionised the treatment of heart failure in patients with left bundle-branch block (LBBB). Its development, founded upon observations that LBBB leads to cardiac impairment,1 progressed to finding that combining a lead implanted on the left ventricular free wall with a lead in the right ventricle could provide drastic improvements in acute cardiac function in patients with LBBB.2 The development of dedicated leads facilitated the fully transvenous approach to BiV-CRT, with the left ventricular free wall targeted by using a ventricular branch of the coronary sinus.
Kaynak: The Lancet
