As we know, heart failure becomes a serious condition when your heart struggles to pump blood effectively. It leads to fatigue, shortness of breath, and swelling in the legs. In some cases, the heart’s chambers do not beat in sync, making the condition worse. In this scenario, the doctors will recommend Cardiac Resynchronization Therapy, or CRT. Hence, in this post, we are going to discuss CRT for heart failure, what the CRT devices for heart failure are, what happens during the treatment, and its benefits.
What Is Cardiac Resynchronization Therapy?
Cardiac resynchronization therapy (CRT) is a treatment that helps to restore the normal rhythm of your heartbeat. It is a procedure to fit a specific type of pacemaker with an additional wire that goes to the left side. It will allow the heart to coordinate the timing between the left and right sides of the heart.
When your heart is not able to pump correctly, the fluid can build up in your lungs and your legs. This is called heart failure. In other cases, this condition can happen when the two bottom chambers of your heart are not able to beat at the same time.
A pacemaker, when combined with an implantable cardioverter defibrillator, helps to fix the timing of the heartbeat and treats dangerous fast heart rhythms. If your heart doctor recommends therapy, it means you need to have a pacemaker placed under your skin by minor surgery.
The wires from the device are connected to the ventricles on both sides of your heart. The device will send electrical signals to the ventricles to make them pump together the way they should. This procedure is also known as biventricular pacing.
What are Cardiac Resynchronization Therapy Devices Used for in Heart Failure?
There are two types of devices for heart failure.
CRT-P (Cardiac Resynchronization Therapy Pacemaker)
Now, CRT-P is a device that is designed to coordinate the heart’s contractions by placing pressure on both the left and right ventricles. It works like a traditional pacemaker but with an extra lead to stimulate the left ventricle. It helps to regulate the heartbeat smoothly, and it sends electrical signals to synchronize the ventricles. It is used in patients with moderate to severe heart failure with a slow or irregular heartbeat. In addition, it improves symptoms like fatigue and shortness of breath.
The device is suitable for patients who don’t have a high risk of cardiac arrest but need help with heart rhythm coordination.
CRT-D (Cardiac Resynchronization Therapy Defibrillator)
A CRT-D is a device that includes all the features of a CRT-P. However, it also has a built-in Implantable Cardioverter Defibrillator (ICD). It means it can deliver a shock to the heart if it detects a life-threatening rhythm, like ventricular tachycardia or fibrillation.
The device coordinates the heart’s pumping action like a CRT-P, and it detects and treats dangerously fast heart rhythms. It delivers defibrillation shocks when needed to prevent sudden cardiac death. Further, the device monitors the heart continuously and offers both long-term pacing and emergency intervention.
The device is suitable for patients who don’t have a high risk of sudden cardiac arrest but need help with heart rhythm coordination.
What Is the Procedure for Cardiac Resynchronization Therapy (CRT) for Heart Failure?
The heart specialist may insert the device on an outpatient basis or if you are staying in a hospital. The procedure may vary, and it depends on the heart condition and the doctor’s practice. You can talk with your doctor about what will happen during your procedure.
Initial Procedure
Usually, the procedure will take from 2 to 3 hours, and you will be awake but relaxed and sleepy during the entire procedure. The doctor will take you to the procedure room, and you will lie down on an X-ray table. Later, an IV line will be inserted into your hand or arm, and the team will give you fluids, antibiotics, and pain medicine through this line.
Incision for Fluids
The team will watch your heart, blood pressure, and oxygen level. Later, the heart specialist will offer you medicines to help you relax or fall asleep, and they will also numb the area where the device will be placed. It is usually just under your left collarbone. Later, the doctor will make a small cut and create a pocket under the skin. The pocket will hold the wires and computer battery pack for the service.
Placing the CRT Device
In the next step, the doctor will put IV lines in the large vein that feeds into your heart, and then the doctor will put CRT wires into the vein, and they will feed them into your heart. There will be a special X-ray which will make sure the leads are in the right place on both sides of your heart. The wires going to the left side will be attached inside a vein that goes around the back left side of the heart. Later, the experts will test the leads with an electric pulse, and it may feel as if your heart is racing.
Last Stage of Treatment
If the leads are in the right place and properly working, they will be attached to the pacemaker, and your healthcare provider will put the pacemaker through the incision and under your skin. Lastly, the heart specialist will close the device with stitches or staples, and a dressing will be put on. After the treatment, follow the instructions given by the doctors, make lifestyle changes, and follow a heart-healthy diet.
Benefits Of Cardiac Resynchronization Therapy (CRT)
The CRT for heart failure works like magic, and it is beneficial for people living with heart failure, especially those with an abnormal heart rhythm. The following are the benefits of cardiac resynchronization therapy.
- It improves heart function, and it synchronizes the contractions of the heart’s left and right ventricles. It helps the heart pump blood more effectively throughout the body.
- The treatment reduces symptoms such as shortness of breath, fatigue, and swelling in the legs, making everyday activities more manageable for patients.
- It offers a better quality of life by improving exercise capacity and overall energy levels.
- A CRT-D device can offer life-saving shocks to restore normal heart rhythms and reduce the risk of sudden cardiac death.
- It increases the survival rate in suitable patients.
- With proper follow-up and medical management, the procedure can extend life expectancy and allow patients to live more active lives.
Risk Factors Of CRT for Heart Failure
As much as CRT is beneficial for many heart patients, it also has some associated risks or complications, including:
- There is a risk of infection during the procedure of implanting the device.
- Minor bleeding can occur near the implant site, especially if patients are on blood thinners.
- Lead displacement can occur when the wires that connect the device to the heart move out of place. The doctor has to reposition it through another procedure.
- A collapsed lung can occasionally happen during lead placement.
- Some patients may react to the anesthesia or materials used during the implant.
- In rare cases, you may experience heart rhythm disturbance, and the device may trigger irregular heart rhythms.
- It is very rare, but the device may stop working correctly, and it may require another replacement surgery.
The patients should go for regular follow-ups, and proper care will help to minimize these risks and ensure the device works effectively.
Conclusion
CRT for heart failure is the implantation of a permanent biventricular pacemaker. It is essential to discuss with your heart specialist about electronic or magnetic objects that may keep your pacemaker from working right. The healthcare expert will check the pacemaker electronically from their office, and they will need to see you regularly after cardiac resynchronization therapy.
The two types of devices serve different purposes and are suitable for various heart conditions. A top cardiology and vascular care center will provide comprehensive cardiology services along with advanced diagnostic tools. Schedule an appointment with our heart specialist to learn more about Cardiac Resynchronization Therapy for heart failure.
FAQs
What Is the Role of CRT in Heart Failure?
Cardiac Resynchronization Therapy (CRT) helps to manage heart failure, and it improves the coordination of heart muscle contractions. In some patients, the heart’s chambers beat out of sync, making it less effective. The CRT device sends electrical signals that resynchronize the heartbeat, and it improves blood flow, reduces symptoms like fatigue and breathlessness, and enhances overall heart function and quality of life.
What Are the Indications for Cardiac Resynchronization Therapy?
Cardiac resynchronization therapy is recommended for patients who have moderate to severe heart failure (NYHA class II-IV), a reduced left ventricular ejection fraction (≤35%). It is beneficial for those with left bundle branch block (LBBB), and these criteria help identify patients who are most likely to benefit from improved heart rhythm synchronization and reduced heart failure symptoms.
What Is the Life Expectancy With a CRT for Heart Failure?
The life expectancy with the device is different from one patient to another, and it depends on the patient’s overall health. Several studies show that treatment can improve survival rates and quality of life in selected patients. It may extend life by several years, especially when combined with medication and lifestyle changes.