Deif B, et al. - In this systematic review and meta-analysis of retrospective cohorts, prospective cohorts, and randomized controlled trials, that compared ventricular arrhythmia (VA) rates between cardiac resynchronization therapy (CRT)-defibrillator (CRT-D) non-responders, CRT-D responders and those with implantable cardioverter-defibrillator (ICD) only, researchers investigated whether CRT with LV epicardial stimulation is inherently pro-arrhythmic and increases VA rates in the absence of reverse ventricular remodeling while conferring an anti-arrhythmic impact in mechanical responders. They found that, compared with CRT-D responders and those with ICD only, CRT-D non-responders experienced more VA. This finding implied that CRT with LV epicardial stimulation may be inherently pro-arrhythmic in the absence of reverse remodeling.