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The importance of increased percentage of biventricular pacing to improve clinical outcomes in patients receiving cardiac resynchronization therapy.

PURPOSE OF REVIEW: To describe the growing evidence that a maximal biventricular pacing is needed to gain the maximal benefits from cardiac resynchronization therapy (CRT).

RECENT FINDINGS: Even small gains in the biventricular (BIV) pacing percentage are clinically important both to prevent acute heart failure and, more importantly, to improve survival.

SUMMARY: Every effort should be made in all patients receiving CRT to approach 100% BIV pacing by a correct device programming, a correct pharmacologic regimen and atrioventricular nodal ablation in atrial fibrillation patients.

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