The width of life is more important than the length of life

Abstract

A 58-year-old man with previous inferior myocardial infarction (MI) was referred for cardiac resynchronization therapy pacemaker (CRT-P) for decreased left ventricular ejection fraction (LVEF; 45%) and left bundle branch block (LBBB) (Figure 1). He had New York Heart Association Class I functional classification but palpitation for 3 months. General physical and cardiac examinations were normal. On the admission day, the electrocardiogram showed a narrow QRS rhythm with and without tachycardia (Figures 2 and 3). Would you recommend or consider a CRT-P device or a CRT defibrillator or only an implantable cardioverter defibrillator (ICD) based on these clinical and electrocardiographic findings, or ablation or medical therapy only.