39
Figure 8. Algorithm for CRT Indications in Patients With
Cardiomyopathy or HFrEF
General health
status
Evaluate LVEF
LVEF ≤35% LVEF 36%–50%
NYHA I
LVEF ≤30%;
Ischemic CM;
LBBB ≥150 ms
(2b)
LBBB ≥150 ms
(1)
AF
RV pacing
frequent
or anticipated
(2a)
NSR
RV pacing
frequent
or anticipated
(2a)
Non LBBB
≥150 ms (2a)
LBBB 120–149
ms (2a)
Non LBBB
120–149 ms (2b)
NYHA II–Amb
class IV
Special
circumstances
High degree or
complete heart
block
(2a)
Comorbidities
limit survival
to <1 y
Continue GDMT
without device
Patients with HF on GDMT >3 mo and >40 d if after MI,
or with a special indication for pacing
