Dr. Gold reviews the history of biventricular pacing from early clinical studies to contemporary devices. Studies such as DAVID, MADIT II, MUSTIC, and others are reviewed with an emphasis on the hemodynamic and clinical applications. Currently the role of CRT is to facilitate drug therapy by preventing bradycardia and minimizing hypotension. The results of the COMPANION and CARE HF studies demonstrate how effectively CRT reduces hospitalization and mortality.