Right Ventricle and Cardiac Resynchronization Therapy. Spectator or Actor?

Lately, RV dysfunction has emerged as a significant prognostic factor in heart failure with reduced ejection fraction (HFrEF). More so, recent data show a specific pattern of RV contraction in LBBB patients that is corrected by CRT, but not in patients with RV failure. The importance of RV evaluation in CRT patients is still under debate. Establishing the role of RV function in the setting of CRT may help identify patients with high risk of adverse events. Moreover, the changes induced by CRT upon RV may lead to a better understanding of the mechanisms behind CRT effects and may facilitate novel criteria for optimal selection of CRT candidates.