Resynchronization Therapy

Cardiac Resynchronization Therapy (CRT): Advanced Treatment for Heart Failure

Cardiac Resynchronization Therapy (CRT) is an advanced treatment for patients with heart failure and abnormal heart rhythms. It uses a special device (similar to a pacemaker) to synchronize the contractions of the heart's ventricles, improving the heart's efficiency and pumping ability.

CRT is also known as a biventricular pacemaker.

Why is CRT Needed?

CRT is recommended for patients whose heart chambers are not beating in coordination, leading to poor blood circulation.

Common indications include:

• Moderate to severe heart failure
• Weak heart pumping (low ejection fraction)
• Bundle branch block (electrical conduction delay)
• Persistent symptoms despite medications

Types of CRT Devices

• CRT-P (Pacemaker): Synchronizes heartbeats, used in heart failure patients without high risk of sudden cardiac arrest
• CRT-D (Defibrillator): Combines CRT with a defibrillator, prevents sudden cardiac death by correcting dangerous rhythms

How Does CRT Work?

• A device is implanted under the skin in the chest
• Leads (wires) are placed in the heart chambers
• The device sends electrical signals to coordinate heart contractions
• This improves blood flow and heart efficiency

How is the Procedure Performed?

• Local anesthesia and sedation are given
• Leads are inserted through veins into the heart
• The CRT device is connected and placed under the skin
• Device settings are adjusted for optimal performance

The procedure usually takes 2–4 hours.

Benefits of Cardiac Resynchronization Therapy

• Improves heart function and efficiency
• Reduces symptoms like breathlessness and fatigue
• Enhances quality of life
• Decreases hospitalizations
• Increases survival in heart failure patients

Risks and Complications

Although generally safe, possible risks include:

• Infection at the implant site
• Bleeding or swelling
• Lead displacement
• Device malfunction (rare)
• Allergic reaction to anesthesia

Recovery After CRT Implantation

• Hospital stay: usually 1–2 days
• Resume light activities within a few days
• Avoid heavy lifting for a few weeks
• Regular follow-ups for device monitoring

Who is a Suitable Candidate?

CRT is ideal for:

• Patients with symptomatic heart failure
• Reduced ejection fraction (≤35%)
• Electrical conduction delays (e.g., bundle branch block)
• Patients not responding well to medications

Living with a CRT Device

• Maintain a healthy lifestyle
• Avoid strong magnetic fields
• Carry a device identification card
• Attend regular follow-ups
• Continue prescribed medications