Biventricular (BiV) pacemakers and pacemaker-defibrillator (ICD) systems have been shown to improve cardiac function and diminish frequency of heart failure hospitalizations in patients with severe left ventricular (LV) dysfunction and intraventricular conduction disease. The basis for these beneficial effects is multifactorial (1-15). In the case of BiV pacemakers, the primary benefit is presumed to be improved synchronization of ventricular contraction in the diseased heart; for BiV-ICDs an additional antiarrhythmic benefit is provided by the defibrillation feature.
Given the potential of an incremental survival benefit with BiV-ICDs versus BiV pacing alone, there has been a trend toward utilizing BiV-ICD devices in
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