Cardiac Resynchronization Therapy: A Review And Future Directions

Abstract

INTRODUCTION In millennia past, descriptions of congestive heart failure (CHF) often included ancient remedies. The earliest Egyptian papyri translated in the last century reveal a remarkably sophisticated understanding of heart ailments being the prime culprit in conditions of generalized edema (also called dropsy) and CHF.1 Starting in medieval times and continuing until the late 19th century, treatment for CHF included bloodletting to restore balance among the four humors.2 Writings as early as 1250 A.D. described using adjunctive pharmacologic therapy such as cardiac glycoside-containing herbal extracts to treat CHF.3 Several centuries ago, William Withering, a physician and botanist, wrote about the clinical effects of a foxglove plant extract in treating CHF. As a result, digitalis and its derivatives became one of the earliest medicines used in heart failure therapy. Rather than bloodletting, medical management of CHF has progressed in the last century to include diuretics to reduce pulmonary conge...