Osmanska J, et al. - Now that recent guidelines endorse cardiac resynchronization therapy (CRT) in mildly symptomatic heart failure (HF), but favor left bundle branch block (LBBB) morphology in patients with moderate QRS prolongation (120–150 ms), researchers performed a single-center retrospective cohort study to assess how many patients hospitalized with HF fulfil these criteria. They analyzed electronic imaging, electrocardiograms, and records of 363 consecutive patients hospitalized with HF (438 admissions). They found left ventricular ejection fraction (LVEF) and QRS criteria for CRT was fulfilled by 22% of elderly real-life patients hospitalized with HF, with a Class I or IIa indication in most of the cases studied. However, the presence of co-morbidities or the need for medical optimization accounted for a substantial proportion of these patients being deemed ineligible. There is room for improvement, despite a reasonable uptake of CRT.