Care-HF CArdiac Resynchronization in Heart Failure

Inclusion Criteria: Heart failure for at least 6 weeks requiring loop diuretics Currently in NYHA class III/IV A high standard of pharmacological therapy LV systolic dysfunction and dilation (EF <=35%; EDD >30mm/height in metres) QRS >=120 ms Dyssynchrony confirmed by echo if QRS 120-149 ms (Aortic pre-ejection delay >140ms, Interventricular mechanical delay >40 ms, Delayed activation of postero-lateral LV wall) Exclusion Criteria: Age < 18 years old or age < legal age defined in the country in case different Chronic atrial fibrillation within 6 weeks prior to randomization; Impairment of left ventricular function not related to left ventricular systolic function Potentially reversible forms of cardiomyopathy: Cardiac surgery, percutaneous coronary intervention, cardiomyoplasty, myocardial infarction,unstable severe angina or stroke within 6 weeks before randomization A conventional indication for bradyarrhythmia pacing exists; A conventional indication for an ICD exists A pacemaker or ICD has already been implanted; In-Patients requiring continuous intravenous therapy for Heart Failure; Life expectancy < 1 year for disease unrelated to Heart Failure; Pregnancy or childbearing potential and not on reliable contraceptive; Mechanical tricuspid valve; Anticipated compliance problem or participation in another trial;