# Cardiac resynchronization therapy in cancer patients with chemotherapy-induced cardiomyopathy: a mini review

## TL;DR

This review discusses the use of cardiac resynchronization therapy in cancer patients with heart damage caused by chemotherapy, highlighting the need for more research.

## Contribution

The paper emphasizes the lack of randomized trials and calls for improved patient selection and long-term evaluation of CRT in chemotherapy-induced cardiomyopathy.

## Key findings

- Current evidence on CRT in chemotherapy-induced cardiomyopathy is limited to small, retrospective studies.
- MADIT-CHIC is the only prospective trial, but more research is needed to assess CRT's long-term benefits and risks.

## Abstract

Chemotherapy-induced cardiomyopathy (CHIC) represents a growing clinical challenge due to the increasing use of cardiotoxic treatments. These therapies can lead to progressive myocardial dysfunction, ultimately resulting in heart failure. Cardiac resynchronization therapy (CRT) has been widely investigated in selected patients with chronic heart failure; however, those with CHIC remain underrepresented in CRT trials. Current evidence is largely based on retrospective and observational studies, with MADIT-CHIC being the only prospective trial to date. No randomized controlled trials are currently available. Despite encouraging findings, existing data remain limited by small sample sizes and short follow-up durations. In particular, the impact of CRT on left ventricular dyssynchrony, arrhythmic burden, and long-term survival in this population has not been fully elucidated. A multidisciplinary cardio-oncology approach is essential not only for the comprehensive management of these complex patients, but also to guide appropriate timing of CRT implantation. Further research is warranted to refine patient selection criteria and to fully assess the long-term benefits and risks of CRT in patients with CHIC.