Abstract
Cardiac resynchronisation therapy is an established therapy for patients with advanced heart failure, decreased left ventricular ejection fraction, a wide QRS syndrome, and the presence of left ventricular dyssynchrony despite optimal pharmacotherapy. The key feature for applied treatment is proper qualification and the optimal placing of left ventricular electrode implantation. The major issues that limit resynchronisation therapy are high left ventricle pacing threshold and phrenic nerve stimulation (PNS). PNS occurs in 30% of patients at implantation. In this paper, we present alternative methods of avoiding PNS based on the latest clinical trials and our own experience.
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