A 79-year-old man refers to our echocardiolab for a normal follow-up after 2 years of biventricular pacing. Seven years before the present observation, the patient underwent a biological aortic valve replacement for severe valvular stenosis in the presence of marked systolic dysfunction of the left ventricle and advanced cardiac failure symptoms. The evaluation of the present and past clinical and echocardiographic parameters suggests that conventional surgery and full medical therapy did not elicit an improvement of both functional and clinical parameters, whereas cardiac resynchronization therapy dramatically improved in the mid term all the clinical and functional parameters.