Cardiac Resynchronization Therapy is a form of treatment for people suffering from certain types of heart failure. These electronic battery powered devices, called CRT or CRT-D for short, have been proven to improve some patients’ ejection fraction by five to ten percent, even up to three times that.
Cardiac Resynchronization Therapy may also be referred to as biventricular pacing and some of the devices that feature this type of pacing therapy may be called a Biventricular Pacemaker. In combination with a defibrillator, this device can be a very effective at keeping a person with severe cardiac illness who exhibit a poor ejection fraction (less than 35%) and are at risk of cardiac arrest alive and in good health. Cardiac Resynchronization Therapy devices are similar to defibrillator implants in size and function, and it is common for many of these devices to feature defibrillation treatment for its user. Defibrillation is proven to be the most effective form for treating Sudden Cardiac Arrest (SCA), so combining the features and benefits of Cardiac Resynchronization Therapy in Biventricular pacemakers with implantable cardioverter defibrillators is commonly chosen as the optimal route for increasing patient health to his/her fullest.
The surgery involved in having a CRT device implanted in your body is almost identical to the procedure for implanting defibrillators and pacemakers. Surgery will usually last two to six hours and the patient will most likely need to stay at the hospital for an additional 24 to 48 hours to receive monitoring and follow-up care to make sure the device is working properly and the patients is in good health. Sometimes the patient may need to stay in the hospital longer depending on the type of surgery conducted to implant the Cardiac Resynchronization Therapy device. Surgery can be performed through one of two methods, endocardial or epicardial surgery. The latter typically requires the patient to stay in the hospital longer due to its procedures being slightly more invasive for the patient. Endocardial surgery is the transvenous approach to placing the leads onto the heart by way of the hearts primary veins. However, this surgical route for implanting a CRT or CRT-D device can be tricky and not always successful because transferring the leads requires the veins leading into the left and right ventricles of the heart to be clear and open, which is not always the case. The epicardial surgey requires longer hospital stays because it is more invasive as the implanted Cardiac Resynchronization Therapy device is placed in the upper abdomen and not in the left pectoral region, which is usually where a defibrillator implant is inserted.
Cardiac Resynchronization Therapy requires two to three leads to be placed in the right atrium, right ventricle, and left ventricle. This allows for simultaneous pacing of the left and right ventricles, also referred to as biventricular pacing. Candidates who receive Cardiac Resynchronization Therapy along with a defibrillator will benefit from the device’s ability to resynchronize the heartbeat, slowdown abnormally fast arrhythmia, prevent slow arrhythmia, and record all data collected through out process of performing these actions. The CRT devices that have a defibrillator are typically referred to as a Cardiac Resynchronization Therapy Defibrillator, and shortened to CRT-D. These revolutionary devices are being tested in clinical environments intensively and early findings are showing that by combining cardiac resynchronization therapy with defibrillation and antitachycardia pacing (ATP), patients are experiencing greater chances of quality long-term health.
For a person to be potentially qualified for receiving Cardiac Resynchronization Therapy, they must have prior history of cardiac illness that includes but is not limited to the following: moderate to sever heart failure and/or symptoms, taking prescribed anti-arrhythmia drugs, intraventricular conduction delay or bundle branch block, and other symtoms of ailing cardiac health. If you have received a pacemaker or a defibrillator implant already and are interested in a Cardiac Resynchronization Therapy device or Cardiac Resynchronization Therapy-Defibrillator device, consult with your health team for the best course of action.