[Current guidelines].

Abstract

Cardiac resynchronisation therapy (CRT) has been adopted fast into clinical practice and current guidelines as a new therapy for some patients with severe systolic heart failure. Current American guidelines have accepted cardiac resynchronisation therapy with the highest level of evidence (A) and have classified the indication in the second highest range (II a). Recommendations in a consensus statement of the German Cardiac Society have been more moderate and have considered contemporarily unsolved questions. After completion of the COMPANION study, which showed a significant benefit for cardiac-resynchronization therapy in the primary end point (mortality and hospitalisation), there were claims for a new evaluation of the cardiac resynchronisation therapy in the German guidelines for cardiac pacing. Contrarily to the American guidelines a risk stratification has been performed into class I (therapy should be performed), class IIa (therapy is reasonable) and class II b (therapy is not unreasonable).