Cardiac resynchronization therapy (CRT) is a type of treatment that your doctor may recommend if your heart is not pumping as well, or as rhythmically, as it should. When your heart doesn’t pump strongly enough, fluid can build up in your lungs and your legs. This is called heart failure. This condition can happen when your 2 ventricles, or bottom chambers of your heart, don’t beat at the same time. With CRT, a pacemaker-like device is used to get your ventricles to beat together as they should. This treatment may help your heart pump more efficiently, improve your heart failure symptoms, and lower your risk for serious heart problems.
Your doctor may find out that you also need an implantable cardioverter defibrillator (ICD). This device helps fix serious heart rhythm problems. If you need this device, it may be combined with the CRT.
CRT therapy requires placing a device under your skin with minor surgery. Wires from the device are connected to the ventricles on both sides of your heart. The CRT device sends electrical signals to the ventricles to make them pump together the way they should. This type of electrical stimulation is called biventricular pacing.
CRT therapy works in about 70% of heart failure cases. Not everyone with heart failure benefits from CRT. For instance, if you have advanced heart failure, you are not as likely to respond to CRT. Overall, CRT may improve your survival, heart function, and quality of life if you have mild to moderate heart failure. It also improves your ability to exercise.
Your doctor may suggest CRT for the following reasons:
CRT is not considered a major or dangerous type of procedure. But like all surgery, it carries some risks:
There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.
You should discuss all the risks and benefits of the procedure with your doctor. He or she will probably instruct you to not eat or drink anything after the midnight before surgery. If you usually take medicines in the morning, ask your doctor if you can take them with a sip of water.
Your healthcare team may ask you to stop taking any medicines that thin your blood several days before the procedure. If you take medicines for diabetes, ask your doctor to help you adjust your dose around your surgery. Let your doctor know about:
Your doctor may Insert your CRT device on an outpatient basis, or as part of your stay in a hospital. Procedures may vary, depending on your condition and your doctor's practices. Talk with your doctor about what will happen during your procedure.
The actual procedure may take from 3 to 5 hours. You’ll probably be awake but relaxed and sleepy during the procedure. This is what you can expect:
You will be moved to the recovery area, where you'll stay until the relaxing medicine has worn off. A healthcare provider will give you pain medicines, as needed. You may need to stay in the hospital for a day or two while your doctor checks and adjusts the settings on your CRT device.
After you leave the hospital, it will be important to follow all of your doctor's advice and keep all follow-up appointments.
Here’s what you can expect once you’re home:
Here are likely long-term instructions for living with your CRT device:
Before you agree to the test or the procedure make sure you know:
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