Advances in cardiac resynchronization and implantable cardioverter/defibrillator therapy: Medtronic Cobalt and Crome.

Cardiovascular implantable electronic devices have revolutionized the management of heart failure with reduced ejection fraction. New device generations tend to be launched every few years, with incremental improvements in performance and safety and with an expectation that these will improve patient management and outcomes while remaining cost-effective. As a result, today's cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillator devices are quite different from the pioneering but often bulky devices of the late 20th century. This review discusses new and improved features developed to target specific needs in managing heart failure patients, some of which are especially pertinent to the current worldwide healthcare situation, with focus on the latest generation of CRTs with defibrillator (CRT-Ds) and implantable cardioverter defibrillators from Medtronic. Lay abstract Cardiac pacemaker devices, especially those that can retune the pumping function of the heart (known as resynchronization therapy) and those that provide shocks to restore a normal heart rhythm (known as implantable defibrillators) have revolutionized the management of heart failure over the last three decades and continue to improve in terms of their safety, effectiveness and battery life. This review discusses new and improved features developed to target specific needs in managing heart failure patients, specifically focusing on the latest generation of devices from Medtronic.