Should We Include a Defibrillator for All Cardiac Resynchronization Therapy?　― Comparison of Cardiac Resynchronization Therapy Without and With Defibrillation ―

mining differences in mortality between these 2 types of device therapies. The latest European guidelines recommend the selection of or CRT-P for based on overall clinical condition, device-related complications, and cost. Factors favoring the use of CRT-P include advanced heart failure, severe renal insufficiency or dialysis, other major comorbidities, frailty, and cachexia. Factors favoring the use of CRT-D include life expectancy >1 year, stable heart failure, NYHA class II, ischemic heart disease (low and intermediate MADIT risk score), and lack of comorbidities. 5 Although these are practical guides for deciding C ardiac resynchronization therapy (CRT) is widely used for patients with heart failure, reduced left ventricular ejection fraction (LVEF), and interventricular conduction delay. 1,2 An implantable cardioverterdefibrillator (ICD) is also used to decrease the risk of sudden cardiac death (SCD) in both ischemic and nonischemic dilated cardiomyopathies. 3,4 When selecting the best device for a given patient, we have to choose between CRT with defibrillation (CRT-D) and CRT without defibrillation (CRT-P).