What is Cardiac Resynchronization Therapy?
Cardiac resynchronization therapy is a device based therapy that uses specialized implanted cardiac devices to coordinate the heart’s lower chambers. A CRT device is placed beneath the skin and connected to the heart through insulated wires, including a pacing lead positioned to help stimulate the ventricles. By delivering carefully timed cardiac pacing signals, CRT may improve heart function, increase cardiac output, and support better blood flow throughout the body. In simple terms, the treatment helps the heart pump blood more efficiently.
CRT may involve a pacemaker alone, known as CRT-P, or a device with an implantable cardioverter defibrillator, known as CRT-D. Most devices continuously monitor the heartbeat, while CRT-D systems can also respond to certain dangerous cardiac rhythm abnormalities. The type recommended depends on the patient’s diagnosis and individual needs.
Why is Cardiac Resynchronization Therapy done?
CRT is generally considered for appropriately selected patients with advanced heart failure, particularly certain severe heart failure patients whose symptoms continue despite optimal medical therapy. Research has shown that CRT can improve symptoms and ventricular function in some people with heart failure and electrical conduction delays.
Before recommending treatment, the healthcare provider reviews the patient’s medical history, diagnostic testing, risk factors, and overall health. Current practice guidelines help the provider determine when to suggest CRT, but not everyone with heart failure will benefit. Medications, lifestyle changes, surgery, or other treatments may be more appropriate in some cases.
Following implantation, follow up appointments allow the healthcare team to evaluate healing, monitor the device, and adjust the device settings when necessary. Many patients experience fewer symptoms, improved activity tolerance, and a greater sense of well being, although individual outcomes vary.
When is Cardiac Resynchronization Therapy Needed?
Cardiac resynchronization therapy may be suggested after an ECG and other testing indicates an irregular heartbeat. Heart failure occurs in various stages, so an ECG may be required to diagnose heart failure if symptoms have not occurred. Symptoms of progressed heart failure that may require CRT include:
- Irregular heartbeat
- Congested lungs and a cough
- Wheezing when breathing
- Shortness of breath
- Rapid breathing
- Chest pain
- Skin appearing blue
- Fainting (syncope)
Dr. Beshai might suggest cardiac resynchronization therapy to manage these symptoms and prevent them from causing more serious complications.
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How is Cardiac Resynchronization Therapy Performed?
Cardiac resynchronization therapy will be performed with sedation to ensure you are relaxed and comfortable. During the procedure, lead wires called electrodes will be inserted through a vein, typically in the collarbones, and guided to the heart. One end of the electrode will be attached to the heart, while the other is attached to a pulse generator. This will be implanted under the skin near the collarbone. The device that is used to regulate the heart will depend on your symptoms and how at-risk you are for sudden cardiac death. A pacemaker may be used to ensure that each area of the heart remains in sync, while an ICD may be used to detect dangerous heart rhythms, shocking the heart in order to prevent failure or sudden cardiac death.
What are the Next Steps After Cardiac Resynchronization Therapy?
After cardiac resynchronization therapy, you will be moved to a recovery room to be monitored. You might feel some soreness in the chest where the device was inserted, but most people can return to their regular activities in just a few days. You will have a follow-up treatment with Dr. Beshai to ensure that the device is working properly. Both the pacemaker and ICD are life-long devices, with no need for replacement or removal. You will want to take extra precautions when it comes to metal detectors and wands. Always let someone know that you have the device first.
Scheduling Your Cardiac Resynchronization Therapy Appointment
Dr. Beshai offers cardiac resynchronization therapy to manage the symptoms of dangerous arrhythmias and prevent heart failure complications. If you think you could benefit from CRT or want to learn more, contact our office and schedule your appointment at the Heart Rhythm Institute of Arizona.
Does cardiac resynchronization work?
Does CRT cure heart failure?
Does CRT improve ejection fraction?
How long does a CRT procedure take?
What is CRT short for?
What is CRT used for?
What is the difference between CRT and pacemaker?
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The Heart Institute of Arizona has a wide array of services that come with our premium care. From in-office dianostics and treatable conditions, to hospital based procedures, we’ve got your heart covered.
Dr. Beshai is a board-certified electrophysiologist internationally renowned and respected for his expertise and research. Having published in major medical journals and travelled all over the world to present research, he is dedicated to providing innovative, state-of-the-art care to his patients.