Systematic Withdrawal of Neurohumoral Blocker Therapy in Optimally Responding CRT Patients

Inclusion Criteria

• •≥18 years
• •CRT implantation
• •* based on class I recommendations of ESC (European society of CArdiology) guidelines:
• •* Left bundle branch block (LBBB) with QRS duration \>150 ms and left ventricular ejection fraction (LVEF) ≤35% who remained NYHA functional class II, III and ambulatory IV despite adequate medical treatment
• •* LBBB with QRS duration 120-150 ms and LVEF ≤ 35% who remain in NYHA functional class II, III and ambulatory IV despite adequate medical treatment
• •At the moment of inclusion: ≥ 6 months after implantation
• •At the moment of inclusion: normalised LVEF (≥ 50%), LVIDD/BSA (left ventricular internal diastolic diameter indexed to body surface area) ≤3.2 cm/m²(woman) en ≤3.1 cm/m² (men) or LVDV/BSA (left ventricular diastolic volume indexed to body surface area) ≤75 ml/m² (women) or ≤75 ml/m² (men)
• •euvolemic clinical state and functioning in NYHA class I