EDITORIAL When Is It Too Late for Cardiac Resynchronization Therapy?

Lehmann et al.1 pointed out that taken to-gether, the large cardiac resynchronization therapy (CRT) trials included 10,803 patients, the majority of who were in congestive heart failure (CHF) New York Heart Association (NYHA) class III, but only 451 patients (4.2%) were class IV. The role of CRT in NYHA class IV patients remained uncertain un-til recently when Lindenfeld et al.2 reported the results of CRT in 217 such ambulatory patients (on no intravenous inotrope therapy) after a me-dian follow-up of 14 months. Death or hospital-ization for any cause was significantly improved in both CRT and CRT-defibrillator patients. The time to all-cause death and heart failure (HF) hos-pitalization was also significantly improved in th