Trip HF Study: Triple Resynchronization in Paced Heeart Failure Patients

Inclusion Criteria: • NYHA class III-IV congestive heart failure, in spite of optimal medical treatment for their congestive heart failure for 1 month. The medical treatment must include a 40 mg/day minimum dose of furosemide (or equivalent); Permanent atrial fibrillation (AF); Left ventricular ejection fraction (LVEF) ≤ 35%; Indication for a pacemaker implantation for a permanent and symptomatic bradycardia, or already implanted pacemaker under the condition that leads positioning corresponds to the criteria described in the protocol; Aortic pre-ejection delay at least equal to 140 ms. Exclusion Criteria: Indication for a cardiac defibrillator; Having presented a myocardial infarct within the previous 3 months; Having undergone cardiac surgery or coronary revascularization procedure within the previous 3 months, or being scheduled for such procedures; Presenting chronic pulmonary insufficiency; Patients whose congestive heart failure requires the use of an intravenous inotropic support; Presenting a dysthyreosis; Having a life expectancy of less than one year, for other reasons than the congestive heart failure; Unable to be followed-up in the scope of the study for geographical reasons; Having refused to give their consent; Minors (age < 18 years) and pregnant women.