RESTORECardiac Resynchronization Therapy for Beta-Blocker Titration in Heart Failure

This study focuses on improving treatment for chronic heart failure, a condition where the heart can't pump blood as effectively as it should. Current treatments involve the use of ACE inhibitors and beta-blockers, like carvedilol or bisoprolol. However, some patients may not tolerate these medications well, and many aren't receiving the doses proven effective in previous clinical trials. The study aims to show that cardiac resynchronization therapy (CRT) can help patients reach the optimal dosage of beta-blockers, even if they're currently on maximum doses and meet international guidelines for CRT. This could lead to better management of heart failure. The main goal is to demonstrate that CRT can help adjust beta-blocker dosages (carvedilol or bisoprolol) to the optimal level, or at least to the effective dose, for heart failure patients already on maximum beta-blocker doses. The study also aims to evaluate the effectiveness of remote monitoring using a telemedicine system for automatically adjusting beta-blocker doses, compared to the standard approach of regular outpatient visits. The clinical response to CRT will be assessed based on whether patients are on the optimal or sub-optimal dosage of beta-blockers.