[Electrical therapy for heart failure. Perspectives for 2011].

Implantable defibrillators (ICDs) and cardiac resynchronization therapy (CRT) represent established treatments for heart failure with positive results from clinical trials. However, for daily practice, several questions on the optimal use remain (e.g., patient selection, imaging, pacing sites). In addition, new treatment options which attempt to improve heart failure by modulating cellular calcium handling and autonomic dysbalance have recently been developed. For cardiac contractility modulation, initial results from randomized trials have been published. At present, the use of vagal stimulation is also being studied in clinical trials in Germany. New approaches refer to stimulation of sympathetic ganglia in the coronary sinus and left ventricular multisite pacing by ultrasound, but are still in the stage of acute testing.