“…19 However, large clinical studies have suggested that CRT-P could contribute by itself to a reduction in mortality by decreasing the incidence of lethal ventricular arrhythmias, 20 supported by the fact that biventricular cardiac pacing produces reverse remodeling with a favorable impact on outcome and can reduce frequency of ventricular arrhythmias. [21][22][23] Concerning reverse remodeling, the process induced by CRT results in both mechanical and electrical stability of the left ventricle, leading to a lower risk of both heart failure (HF) and arrhythmic events; as shown by Barsheshet et al, 24 a favorable [>25% reduction in left ventricular end-systolic volume (LVESV)] echocardiographic response to CRT-D is associated with a significant 55% reduction in the risk of ventricular arrhythmias compared with ICD-only therapy.…”