What is Cardiac Resynchronization Therapy (CRT)?
Heart failure is the result of a damaged heart muscle. A heart with damaged muscle is a less effective pump resulting in a reduced ability to supply oxygen to meet the needs of the body and brain.
Selected patients with moderate to severe heart failure may benefit from Cardiac Resynchronization Therapy (CRT). CRT, in combination with stable optimal medical therapy, may help the lower chambers of the heart beat together and improve the heart's ability to supply blood and oxygen to the body. Cardiac Resynchronization Therapy is designed to help the two lower heart chambers, the right and left ventricles, beat at the same time in a normal sequence treatingventricular dysynchrony.
The CRT device is similar to a pacemaker. It is placed (implanted) under the skin of the upper chest. CRT is delivered as tiny electrical pulses to the right and left ventricles through three or four leads (soft insulated wires) that are inserted through the veins to the heart. These tiny impulses are small and not normally detected by the individual. Note the diagram to the right.
Cardiac Resynchronization Therapy may be prescribed for someone suffering from heart failure, but it is not a replacement for drug therapy. It is recommended that anyone choosing to receive CRT continue taking medications as prescribed by their physician.
In some patients, cardiac resynchronization therapy has been shown to:
- Improve the ability to exercise and perform other physical activities
- Improve quality of life
- Improve the NYHA functional class (Class III, IV -- the heart failure classification system developed by theNew York Heart Association widely used in the diagnosis of heart failure)
Some heart failure patients are also at high risk of dangerously fast and life threatening heart rhythms (Ventricular Tachycardia and Ventricular Fibrillation). For those patients, cardiac resynchronization therapy (CRT) may be combined with implantable cardioverter defibrillator (ICD) therapy.
What is Cardiac Resynchronization Therapy (CRT) plus ICD Therapy?
Some individuals with a damaged heart muscle are also at high risk for dangerously fast and life threatening heart rhythms, Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF). Patients with heart failure who are also at high risk for VT and VF may require a CRT device that includes implantable cardioverter defibrillator (ICD) therapy. The CRT device plus ICD system is designed to help the two lower heart chambers, the right and left ventricles, beat at the same time in a normal sequence treating ventricular dysynchrony. Additionally, should an individual experience an episode of VT or VF, the system will detect the life-threatening arrhythmia and automatically correct the heart's rhythm.
Am I a Candidate for Cardiac Resynchronization Therapy?
You may be a candidate for cardiac resynchronization therapy if you have moderate to severe heart failure as well as ventricular dysynchrony. Ventricular dysynchrony means that the two lower chambers of the heart (known as the left and right ventricles) are not beating together as they do normally. This condition impairs the ability of your heart to pump blood efficiently and as a result, it impacts your quality of life.
Only your doctor can help you determine if cardiac resynchronization therapy is appropriate for you.
What Does the Implant Procedure Involve?
Implanting any of CRT device (Cardiac Resynchronization or Cardiac Resynchronization plus ICD) is a medical procedure. The system is placed under the skin of the chest and connected to three of four leads (soft insulated wires) that are inserted through veins into the heart.
During the procedure, you are given medication to make you sleepy and comfortable. After the implant, you will look the same as before. You may see a slight bulge under your skin where the device is located. The leads are quite thin and not visible. You will usually stay in the hospital overnight.
During your hospital stay, the doctor or nurse will use a specialized computer to determine how your system is working.
After the procedure, you will receive instructions on how to care for the incision while it heals. When you are recovering at home there are some restrictions as to arm movement for a short period of time after surgery.
Questions regarding cardiac resynchronization therapy, please call 847.570.2640.