<International Circulation>:The indications of CRT and ICD therapy overlap patient suitable for CRT may have indications for ICD， no matter the primary or secondary prevention of sudden cardiac death. And most clinical trials with positive results were based on CRT-D therapy. Dose this mean that CRT-D was preferred to CRT-P in any situation? Considering the financial problems and clinic outcomes， how can we optimize these choices?

   《国际循环》：CRT和ICD的适应症有重合之处，适合CRT治疗的患者可能具有ICD植入指征，无论是从SCD的一级预防或者二级预防的角度。并且绝大部分得出阳性结论的临床研究都是基于CRTD的。这是否意味着在任何情况下CRTD都优于CRT？考虑到患者的经济问题和临床结果，我们该如何选择？
 

    Prof Vardas: it is true that the guidelines do not separate clearly who should receive CR T P or D. I would like to remind you that 80% of the implanted devices in Europe are CRT-D. This is because the physicians are more comfortable with their patients using the defibrillation system as a protectectiv e device. I accept that the CRT-D device is more expensive but to a significant degree provides better protection for patients with low ejection fractions.
 

    Vardas教授:指南确实对于什么患者应该接受CRT-P还是CRT-D清晰地划分。我想提醒你在欧洲80%的植入设备为CRT-D。这是因为医生更习惯让他们的患者使用保护性设备即除颤器系统。我认为CRT-D设备更昂贵但是它可以在很大程度上为低射血分数的患者提供更好的保护。

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