The ACCF/AHA/HRS has updated their 2008 guidelines on indications for device therapy of rhythm abnormalities. Cardiac resynchronization therapy (CRT) Class I indications now include those with a LBBB and QRS >150 ms, and has been expanded to those with NYHA Class II CHF symptoms. Class IIa indications include those with EF<35%, LBBB with QRS 120-149 (or non-LBBB with QRS>150) and Class II-IV symptoms. They recommend against CRT in those with Class I-II symptoms, non-LBBB with QRS<150, or those with expected survival < a year. The full guidelines can be found at (site)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.