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The benefit of cardiac resynchronisation therapy (CRT) implantation in selected patients with heart failure is well known. The number of upgrade procedures is increasing but data on clinical response and outcome are less well documented as compared to implantation. To investigate the efficacy and outcome of CRT upgrade procedures in patients with existing cardiac implantable electronic devices (CIEDs). Baseline characteristics, change in New York Heart Association (NYHA) functional class, echocardiographic parameters, life-threatening v