| Objectives To evaluate the long-term clinic therapeutic efficiency and prognostic value of cardiac resynchronous therapy (CRT) for refractory heart failure and to study the follow-up methodology . Methods Thirty-six consecutive patients with refractory heart failure came into the study gradually. The patients were divided into 2 groups based on their agreement, with 18 cases for CRT and another 18 cases for drugs. There was no statistic significance in clinical character between the two groups. All the patients had indication of CRT. Cases of CRT group were given right atrium and biventricular or pure biventricular pacing, and received strict follow-up and the pacing parameter were optimized dynamically. Meanwhile, all the patients received regular anti-heart failure management. Results The CRT group mean follow-up duration :24.7+12.38(l-48)months, the drug group:20.94+ 10.49 (1-38)months. By optimizing pacing parameters individually and rational medication, CRT could reverse ventricular remodeling, decrease hospitalization event and mortality for heart failure. At the same time, CRT patients' clinic symptoms, heart function, quality of life (QOL) and distance of 6 minutes walk test(6MWT) had improved significantly. Furthermore, the all observed index were statistic significant compared to the drug group. Conclusions Compared with the drug group, CRT plus rational medication may postpone the process of heart failure, abate rate of hospitalization event and mortality, improve survival prognosis for some patients with refractory heart failure. Meanwhile, CRT can also relieve patients' clinic symptoms, improve cardiac function, enhance cardiac function, elevate QOL, increase exercise capacity in long run. Therefore, rational medication, dynamic folio wing-up and individual parameter optimization are the key to successful CRT. In a word, CRT may be considered a useful, adjunct management in some patients with refractory heart failure.
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