How to improve outcomes with cardiac resynchronisation therapy: importance of lead positioning.

Cardiac resynchronisation therapy (CRT), by retiming the failing heart, improves symptoms, reduces hospitalisations and improves survival in patients with left ventricular dysfunction and QRS prolongation. However, not all patients "respond" to CRT. Successful CRT depends on appropriate patient selection, optimal lead positioning, device programming/optimisation and optimal medical therapy. This review article focuses on the importance of lead positioning in improving outcomes.