Abstract
Heart failure affects approximately 1 – 2 % of the adult population in developed countries with the prevalence rising to ≥ 10 % among persons 70 years of age or older. Based on optimal medical treatment, additional electrical therapy might be beneficial for selected patients. For symptomatic patients with systolic dysfunction, wide QRS complex and left bundle brunch block Cardiac Resynchronization Therapy has a class I recommendation. For patients with a normal QRS duration Cardiac Contractility Modulation has been proven to be effective. Recently, there is raising attention on autonomous modulation for heart failure to restore sympathetic-parasympathetic balance.