Cardiac Resynchronization Therapy (CRT)

Cardiac Resynchronization Therapy (CRT) is a treatment for heart failure that involves the use of a device to coordinate the beating of the heart's chambers. The goal of CRT is to improve the heart's pumping function and reduce symptoms of heart failure.

How it Works

CRT devices, also known as biventricular pacemakers, are implanted under the skin and connected to the heart through leads (thin, insulated wires). The device sends electrical impulses to both ventricles (the lower chambers of the heart) to synchronize their contractions. This helps to improve the heart's pumping efficiency and reduce strain on the heart.

Indications

CRT is typically recommended for patients with:

• Severe left ventricular systolic dysfunction (e.g., ejection fraction ≤35%)
• Symptomatic heart failure (e.g., shortness of breath, fatigue, swelling)
• Left bundle branch block or other conduction abnormalities on electrocardiogram (ECG)
• New York Heart Association (NYHA) class III or IV heart failure

Benefits

CRT has been shown to:

• Improve symptoms of heart failure, such as shortness of breath and fatigue
• Enhance exercise tolerance and quality of life
• Reduce hospitalizations due to heart failure
• Prolong survival in patients with severe heart failure

Risks and Complications

As with any medical procedure, CRT carries potential risks and complications, including:

• Infection or bleeding at the implant site
• Damage to surrounding tissues or nerves during lead placement
• Pacemaker syndrome (e.g., dizziness, lightheadedness, palpitations)
• Battery depletion or device malfunction requiring replacement or repair

Device Components

A CRT device typically consists of:

• A pulse generator (the main device component that contains the battery and electronic circuitry)
• Leads (thin, insulated wires that connect the pulse generator to the heart)
• Electrodes (small sensors at the tip of each lead that detect electrical activity in the heart)

Follow-up Care

After CRT device implantation, patients require regular follow-up appointments with their healthcare provider to:

• Monitor device function and adjust settings as needed
• Assess heart function and overall health status
• Address any concerns or issues related to the device or underlying heart condition

Frequently Asked Questions (FAQs)

What is Cardiac Resynchronization Therapy (CRT)?
A treatment for heart failure that involves coordinating the beating of the heart's chambers.

Who is eligible for CRT?
Typically patients with certain types of heart failure and evidence of dyssynchrony, or uncoordinated heartbeats.

How does CRT work?
By using a pacemaker to synchronize the contractions of the left and right ventricles.

What are the benefits of CRT?
May improve symptoms, increase energy levels, and reduce hospitalizations due to heart failure.

Is CRT a surgical procedure?
Yes, it typically involves implanting a device under the skin, often near the collarbone.

What is the success rate of CRT?
Varies depending on individual patient factors, but generally around 70-80% of patients show improvement.

Are there risks associated with CRT?
As with any surgical procedure, risks include infection, bleeding, and device malfunction.

Can CRT be used in combination with other treatments?
Yes, often used in conjunction with medications and other therapies to manage heart failure.

How long does the CRT device last?
Typically 5-7 years, depending on the type of device and individual patient factors.

Does CRT cure heart failure?
No, it is a treatment to manage symptoms and slow disease progression, not a cure.