Cardiac resynchronization therapy in heart failure - Beyond the standard

Cardiac resynchronization therapy device (CRT- defibrillator and CRT-pacemaker) implantations have increased remarkably over the last decade. Conventionally these devices are used in patients with symptomatic systolic left ventricular (LV) dysfunction who either have electrical or mechanical evidence of ventricular dyssynchrony or have bradycardia with high requirement of ventricular pacing. We report three cases in which patients without the standard indications for CRT derived remarkable benefit from biventricular pacing. The clinical considerations in patient selection and device implantation have been highlighted.