A Study of Triple-site Ventricular Pacing in Patients Who Have Not Responded to Conventional Dual Ventricular Site Cardiac Resynchronization Therapy

TRIple-site VENTricular Pacing in Non-responders to Conventional Dual Ventricular Site Cardiac Resynchronization Therapy

Patients are randomised to receive ongoing optimised device and medical therapy or triple ventricular site resynchronisation. The hypothesis states that patients receiving triple-site resynchronization will exhibit a better response.

Inclusion Criteria:

• Implanted with a CRT device > 6 months previously according to current and conventional CRT indications
• Device optimization > 1 months previously
• Aged 18yrs or older
• Able to attend outpatient follow up

Exclusion Criteria:

• Recent MI (<2 months)
• Women who are pregnant or planning pregnancy
• Severe co morbid illness (where patients are not expected to survive duration of follow up period or where repeated outpatient visits may not be in best interest of patients)
• Upgrade procedure is contraindicated for safety reasons.
• Class IV inotropic agents
• Patient unwilling to comply with required follow-up protocol including randomization scheme