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In order to help individuals with heart failure improve their blood flow, a specialized device called a Cardiac Resynchronization Therapy Pacemaker (CRT-P) is implanted in the chest. It makes sure the two ventricles beat in unison for improved heart function by sending them electrical signals.
Cardiac Resynchronisation Therapy (CRT) is used for patients with moderate to severe heart failure who have left bundle branch block or other aberrant electrical transmission in the heart. It is usually advised when medications are no longer adequate or when a pacemaker or defibrillator is required. CRT can boost quality of life, decrease the risk of hospitalisation, improve cardiac function, and lessen symptoms like shortness of breath. Generally speaking, people with mild heart failure shouldn't do it.
A cardiologist should be consulted if you suffer from signs of heart failure, such as palpitations, limb oedema, shortness of breath, decreased exercise capacity, or chronic weariness. If you have a history of arrhythmias, low ejection fraction, or heart disease, routine testing and follow-ups can help establish whether CRT-P is required. Certified cardiologist specialists are easily accessible through MediGence for thorough assessments and individualised treatment plans.
A comprehensive cardiovascular evaluation, which includes an ECG, echocardiography, chest X-ray, blood tests, and potentially cardiac MRI or electrophysiology testing, is the first step in preparation. Your physician will evaluate the electrical and mechanical functioning of your heart. Fasting will be necessary on the day of implantation, and you might be told to stop taking some medications before the surgery. Your medication list and medical history will be thoroughly reviewed to inform the pre-procedure planning.
- Implantation of the Device: The pacemaker is placed beneath the skin, close to the collarbone. To resynchronise heartbeats, leads (wires) are inserted through veins into the right atrium, right ventricle, and a coronary vein above the left ventricle.
- Testing and Programming: After the leads are positioned, the CRT-P device is tested and programmed to guarantee peak performance.
- Closure and Monitoring: Depending on the patient's state, the incision is closed after implantation, and the patient is kept under observation for a few hours or overnight.
The average time for CRT-P implantation is two to four hours. The majority of patients spend one to two days in the hospital. During the one to two weeks it typically takes for full recovery, patients are encouraged to minimise physical strain and arm mobility.
- Infection
- Bleeding
- Lung collapse
- A hole in a heart chamber that results in the accumulation of blood and fluid in the sac that surrounds the heart
- The device's failure
- Movement of the device's components, which could need to be fixed by another process
CRT-P enhances heart contraction coordination, raising cardiac output, lessening heart failure symptoms, and enhancing quality of life. It increases exercise tolerance, reduces hospitalisations, and extends survival in qualified individuals.
Patients are advised on wound care, activity restrictions, and recognising potential issues after surgery. Follow-up visits are planned to monitor device function and make programming adjustments. Heart function is evaluated through routine imaging and functional tests. For the best recovery, cardiac rehabilitation may be advised.
About 70% of carefully chosen patients who receive CRT-P report significant symptom relief and better cardiac function, indicating a high success rate.
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