Cardiac resynchronization therapy (CRT) is treatment to help your heart beat with the right rhythm. It uses a pacemaker to restore the normal timing pattern of the heartbeat.
The CRT pacemaker coordinates how timing of the upper heart chambers (atria) and the lower heart chambers (ventricles). It also works on the timing between the left and right sides of the heart.
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 the two bottom chambers (ventricles) of your heart don’t beat at the same time.
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 means you will need to have the pacemaker placed under your skin by 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 7 out of 10 cases of heart failure. Not everyone with heart failure can be helped by 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. They include:
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 tell 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:
Your doctor will give you medicines to help you relax or fall asleep. The doctor will also numb the area where the device will be placed. This is usually just under your left collar bone (clavicle).
You will be moved to the recovery area. You will stay there 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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