More than two decades after the introduction of cardiac resynchronization therapy (CRT) into clinical practice, respond to highly effective treatments for refractory drug heart failure (HF) approximately one-third of candidates persist to fail. This article will discuss indications for initiating a CRT, the definition of a response to a CRT, steps in response to a CRT, predictors of a CRT response, clinical judgment of patients who do not respond to CRTs, and elimination for possible reversible non-response causes. Here we have reviewed non-response CRTs in many ways. In short, multidisciplinary efforts are needed to overcome them because of the multifactorial causes of non-response (NR). So far, several factors has slowed the progress, such as limitations of NR consensus definitions and technology for therapeutic delivery.Keywords: Cardiac Resynchronization Therapy, Responder, Non-responder
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