Cardiac resynchronization therapy--how big of a miracle?

This review examines the clinical benefit of cardiac resynchronization therapy (CRT) in patients with severe heart failure symptoms and interventricular conduction delay. The magnitude of CRT effects on exercise duration, quality of life, and reversal of adverse remodeling are compared to angiotensin-converting enzyme (ACE) inhibitor therapy and combined beta-blocker/ACE inhibitor therapy. Overall, CRT delivers substantial improvement in clinical well-being to an extent similar to or greater than what would be expected with neurohormonal intervention alone.