Table 8.

Actual European recommendations for cardiac resynchronization therapy

Sinus rhythm

NYHA function class III/IV LVEF ≤ 35% QRS ≥ 120 ms Optimal medical therapy Class IV patients should be ambulatorya

NYHA function class II LVEF ≤ 35% QRS ≥ 150 ms Optimal medical therapy

Atrial fibrillation

NYHA function class III/IV LVEF ≤ 35% QRS ≥ 130 ms Optimal medical therapy Pacemaker dependency induced by AV nodal ablation or slow ventricular rate and frequent pacingb

Pacemaker indication LVEF ≤ 35%c

Notes:

^aNo admissions for HF during the last month and a reasonable expectation of survival >6 months;

^bFrequent pacing is defined as ≥95% pacemaker dependence;

^cIndication IIa^C in NYHA II-IV and IIb ^C in NYHA II.

Abbreviations: AV, atrioventricular; HF, heart failure; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association.