Is There a Role of Adding Defibrillation to Cardiac Resynchronization Therapy for Primary Prevention in Patients with Heart Failure and Reduced Ejection Fraction?

Heart failure with reduced ejection fraction (HFrEF) is a major global health concern, and the mortality rate remains high despite advances in medical and device therapies. Cardiac resynchronization therapy with a pacemaker (CRT-P) and implantable cardioverter-defibrillator (ICD) therapies have demonstrated efficacy in improving outcomes for patients with heart failure, but their roles in combination for primary prevention remain under ongoing investigation. This review explores the current literature on the role of adding defibrillation to CRT for primary prevention in HFrEF patients. We examine key studies, mechanisms of action, and clinical outcomes to evaluate the benefits, risks, and future directions of this combined approach.