CRT may be considered for patients in permanent AF who are otherwise suitable for this therapy (Recommendation Weak, Quality Low).

Values and Preferences This recommendation places great value on the inclusion criteria of the landmark trials, the characteristics of the patients enrolled, the derived benefit of CRT in patients with permanent AF, and the quality of the evidence.

Practical Tip The amount of biventricular pacing needs to be evaluated. Arrhythmia device counters alone might not accurately reflect the true percent of biventricular pacing. It is important to ensure a very high percentage of biventricular pacing. AV junctional ablation might be necessary to achieve sufficient biventricular pacing.