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Cardiac resynchronization therapy(CRT)is an effective treatment for patients with drug-refractory,chronic heart failure.Current guidelines consider CRT as a Class I indication for heart failure patients in New York Heart Association(NYHA)functional class Ⅲ to Ⅳ with depressed left ventricular(LV)ejection fraction≤0.35 and a wide QRS complex≥120 ms.However,there are relative large numbers of nonresponders to CRT.How to improve the responder rate in patients undergoing CRT according to current guidelines is a major task in the future.An integrated approach evaluating LV dysynchrony,total myocardial scar burden,and cardiac venous anatomy may refine the selection of potential responders to CRT.Moreover,to expand patient groups that might also benefit from CRT is also equally important.REVERSE and MADIT-Ⅱ trials have demonstrated that the effect of CRT to improve LV function and prevent heart failure progression in mildly symptomatic heart failure patients.Perhaps attenumion of disease progression will prove to he a successful new treatment strategy in heart failure patients in the future.In addition,other clinical conditions,such as atrial fibrillation patients,upgrading from right ventricular pacing,right-sided heart failure,and congenital heart disease,have also demonstrated clinical benefit from CRT.However,more data are needed in these subpopulations.