Biventricular pacing for congestive heart failure.

Resynchronization with biventricular pacing is a relatively new and important nonpharmacological therapy for patients with heart failure. A prolonged PR interval, a wide QRS, and left bundle branch block are typical conduction disturbances associated with left ventricular dysfunction. The intraventricular conduction delays often lead to loss of synchronization of ventricular contraction, thus contributing to additional problems for the heart failure patient. Biventricular pacing offers (surgically implanted leads implies a thoracotomy or mini-thoracotomy for an epicardial lead and not the preferred transvenous approach) for an endocardial lead, considerable promise for improving the quality of life, exercise tolerance, as well as for decreasing hospitalization for patients with Class III or Class IV heart failure.