Zhang Y, et al. - Researchers compared four different cardiac resynchronization therapy (CRT) optimization methods with respect to long-term clinical outcomes in this study with 124 consecutive CRT patients with severe heart failure and left bundle-branch block configuration. In a random manner, the participants were allocated to four groups to undergo atrioventricular (AV)/ventricular-to-ventricular (VV) delay optimization via echocardiogram (ECHO; n = 30), electrocardiogram (ECG; n = 32), QuickOpt algorithm (n = 28), and nominal AV/VV (n = 36) groups. At 6 months, significant improvements in left ventricular end diastolic diameter, left ventricular ejection fraction, 6-min walking distance, and New York Heart Association were evident in ECHO, ECG, and QuickOpt, but no significant improvements were seen in any of the groups at 12, 24, and 48 months. Overall, no significantly different long-term impact of the four CRT methods for heart failure was evident in this study.