We recommend that all patients with HF who are planned to receive a CIED system revision should be considered for their eligibility for upgrade to CRT.
(Strong Recommendation, Low-Quality Evidence)

Values and preferences: Careful evaluation of the risks and benefits of upgrades in patients with existing CIED systems who are eligible for CRT should be considered.

Practical tip: Considering the expanding indications for CRT and the changes over time that might occur in a patient’s condition, the need for CRT should be considered at the time of CIED change, because risk/benefit of adding an LV lead when a procedure is being performed might be favourable. For further details, refer to Figure 1.