Cardiac resynchronization therapy guided by cardiovascular magnetic resonance

Table 1 European Society of Cardiology guidelines for cardiac resynchronization therapy (2010 Update).*

Recommendation	Patient population	Class	Level
Sinus rhythm
CRT preferentially by CRT-D is recommended to reduce morbidity or to prevent disease progression	NYHA class II	I	A
	LVEF ≤ 35%, QRS ≥ 150 ms
CRT-P/CRT-D is recommended to reduce morbidity and mortality	NYHA class III/IV	I	A
	LVEF ≤ 35%, QRS ≥ 120 ms
	Optimal medical therapy
Atrial fibrillation
CRT-P/CRT-D should be considered to reduce morbidity	NYHA class III/IV	IIa	B
	LVEF ≤ 35%, QRS ≥ 130 ms
	Permanent dependency induced by AV nodal ablation
CRT-P/CRT-D should be considered to reduce morbidity	NYHA class III/IV	IIa	C
	LVEF ≤ 35%, QRS ≥ 130 ms
	Slow ventricular rate and frequent pacing
Concomitant Class I pacemaker indication
CRT-P/CRT-D is recommended to reduce morbidity	NYHA class III/IV	I	B
	LVEF ≤ 35%, QRS ≥ 120 ms
CRT-P/CRT-D is recommended to reduce morbidity	NYHA class III/IV	IIa	C
	LVEF ≤ 35%, QRS < 120 ms
CRT-P/CRT-D is recommended to reduce morbidity	NYHA class II	IIb	C
	LVEF ≤ 35%, QRS < 120 ms

*Recommendations according to presence of sinus rhythm, atrial fibrillation or concomitant conventional pacemaker indications, taken from Dickstein K, et al. [126] Class and level of evidence is shown in the columns. CRT-P = cardiac resynchronization therapy pacing; CRT-D = cardiac resynchronization therapy - defibrillation.

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