Advances in Cardiac Resynchronization Treatment

Dear Colleagues,

Resynchronization treatment has changed over the last few years with the advent of novel technologies. Moreover, conduction system pacing has become widely accepted by electrophysiologists. Such procedures now merit more theoretical background and specific equipment with a view and vision to evolve and change the conventional resynchronization treatment means. Preliminary data already suggests that electrical resynchronization is superior to the one achieved by biventricular pacing. Numerous randomized studies are in progress in order to provide us with robust data on this field. There are different aspects in which conduction system pacing can be helpful. It is not only in bailout cases where a difficult coronary sinus anatomy hinders the implantation of a left ventricular lead. There is preliminary data indicating that this novel method can be used a) in the index resynchronization procedure; b) to reverse pacing-induced cardiomyopathy and c) to render patients responders to resynchronization treatment in cases where this was not achieved by the current traditional strategy. Apart from this, emerging techniques promise resynchronization with the use of leadless devices. Novelty is not limited to emerging, cutting-edge technology but also focuses on sudden cardiac death risk stratification. It is a long-standing debate whether patients should receive a defibrillator along with a biventricular device. It seems that it is time to shift the decision-making process by applying a multifactorial risk stratification model. This effort will introduce a more individualized approach and stratify patients not solely based on systolic function, as it stands now for primary prevention under current guidelines. This multi-step strategy is supposed to detect a group of patients that are essentially at risk, but defibrillator treatment is underutilized due to the current gap in evidence. The scope of this Special Issue is to address the aforementioned topics through original investigations and review articles.

Dr. George Leventopoulos
Prof. Dr. Konstantinos A. Gatzoulis
Prof. Dr. Nikolaos K. Fragakis
Guest Editors

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• conduction system
• risk stratification
• resynchronization
• cardiac pacing
• sudden cardiac death