Abstract
Introduction: Normal ventricular function requires synchronous activation mediated by intact native conduction that efficiently distributes activation throughout the ventricular endocardium. Cardiomyopathy with severely depressed ventricular systolic function and chamber dilatation manifests dyssynchronous activation and discordant contraction mechanics due to differential regional delay. We propose that CRT optimally should not bypass the native conduction system, but rather correct regional delay in native activation.
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