Innovations in the development of cardiac resynchronization therapy devices with defibrillation capability-the Boston Scientific experience.

Cardiac resynchronization therapy (CRT) has been clinically proven to improve symptoms, exercise capacity, and quality of life and promote reduction in ventricular dimensions. When combined with a defibrillator (CRT-D), significant reductions in all-cause mortality alone and in combination with cause-specific hospitalization have also been demonstrated. We trace Boston Scientific Corporation's experience in the development of CRT-D devices from the first human implant worldwide 10 years ago using transthoracic lead technology, through the clinical studies that led to regulatory approval using transvenous leads and pulse generators with features specifically designed for heart failure patients. We conclude with innovations for CRT-D that are currently under study.