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Heart failure (HF) continues to grow and affect more than five million people in the USA. One of the leading device therapies in HF is cardiac resynchronization therapy (CRT) which has been studied for over 20 years. Recent advancements in lead placement, lead technology, patient selection, and CRT optimization by electrical maneuvers and imaging modalities have improved outcomes in morbidity, hospitalization reductions and mortalities in those who have responded CRT therapy. This review article is intended to discuss the mechanisms and benefits of CRT, clinical trials, and guidelines for CRT along with a focus on recent updates from the past 3 to 5 years and glimpse into future directions.

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.

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Introduction: There is growing popularity in social media use among physicians and health care practitioners for data collection and health promotion among cardiovascular disease. However, there is little knowledge regarding the ongoing dialogue, and who are communicating. Hypothesis: This is an exploratory study to capture the users and contents of tweets related to heart failure. Methods: We searched Twitter for these hash users and the hashtags #chf #congestiveheartfailure and #heartfailure between the dates of January 2017-March 2017. We we categorized the type of user and content of each tweet. For any discrepancies for categorization, another reviewer would examine the tweet. For the hashtag #heartfailure as there were more than 2500 tweets per month, we randomly selected 5% of tweets to hand code. Results: During this time period, users infrequently used #congestiveheartfailure and #chf, with only 37 and 222 tweets respectively, while #heartfailure was more commonly used. Within our random sample of coded tweets, 29.4% (204/693) of tweets were from patients, caretakers, or advocacy groups, while 35.2% (244/693) were from physicians, academic journals, medical groups, and industry. The most common content areas were medical education (such as journal articles) (34.6%, 240/693), disease awareness and advocacy (18.76%, 130/ 693), and personal experience (16.3%, 113/693). There was little overlap between discussions from patients and academic discussions, and lack of patient and academic engagement. There were few tweets of patients sharing journal articles (2 tweets), and by the lack of retweets between patients and physicians. Conclusions: Twitter, a social media platform, is used by both health care providers and patients. However, conversations are significantly siloed, and engagement between laypersons/advocacy groups and professionals were not observed.