Introduction

What Is Cardiac Resynchronization Therapy (CRT)?

Heart failure patients may experience symptoms such as shortness of breath and body swelling due to the heart’s reduced ability to pump blood efficiently. Cardiac Resynchronization Therapy (CRT) is a treatment that uses a special type of pacemaker to improve the coordination of the heart's contractions, particularly between the left and right ventricles. This synchronization can enhance the heart’s pumping efficiency, alleviate symptoms, and improve overall heart function.

Causes

Causes

Heart failure may result from various underlying conditions that weaken or damage the heart muscle, including coronary artery disease, heart attack, high blood pressure, cardiomyopathy, and heart valve disease. These conditions can disrupt the heart’s normal electrical conduction, leading to asynchronous ventricular contraction and worsening heart function.

Symptoms

Symptoms

Common symptoms of heart failure include:

  • ● Shortness of breath, especially during physical activity or while lying flat
  • ● Swelling of the legs, ankles, or abdomen
  • ● Fatigue and weakness
  • ● Rapid or irregular heartbeat
  • ● Difficulty exercising
  • ● Persistent coughing or wheezing
  • ● Sudden weight gain due to fluid retention
Operation

The Cardiac Resynchronization Therapy (CRT) Procedure

CRT is an invasive procedure usually performed under local anesthesia in the Cardiac Catheterization & Intervention Laboratory (CCIL). During the procedure:

  • ● You will remain awake but may receive sedation to help you relax.
  • ● Electrodes will be placed on your chest to monitor heart rate and rhythm. A pulse oximeter will be clipped to your finger to measure oxygen levels, and your blood pressure will be checked regularly.
  • ● The skin below your left (or sometimes right) clavicle will be disinfected, and a small incision (about 3–5 cm) will be made.
  • ● Contrast dye may be injected to visualize the veins, and a needle puncture under the clavicle will provide access to the vein.
  • ● Three leads (wires) will be guided through the vein into the heart chambers under X-ray guidance. One lead is placed in the right atrium, one in the right ventricle, and a special lead in a vein over the left ventricle (the coronary sinus).
  • ● The leads will be connected to a generator (the pacemaker device), which will be implanted in a pocket under the skin or muscle.
  • ● The wound will be closed with sutures and covered with a pressure dressing.
  • ● The entire procedure typically takes about 3–4 hours.
Notice

Postoperative Care

  • ● You may be discharged from the hospital a few days after the procedure.
  • ● Keep the wound clean and dry. Avoid getting the dressing wet during showers. Replace the dressing if it becomes wet.
  • ● If stitches are present, you may need to return to the clinic for suture removal about one week later. The dressing can usually be removed 2–3 days after that.
  • ● Avoid lifting the affected arm above shoulder level and refrain from vigorous arm movements for at least 1 month.
  • ● You will be scheduled for regular CRT follow-up visits, including device programming and battery checks. Echocardiograms may be used to optimize device settings.
  • ● Always carry your CRT identification card.
  • ● Follow your doctor’s instructions and the device manufacturer's guidelines to minimize electromagnetic interference. Keep mobile phones at least 15 cm (6 inches) away from the device. Most household appliances are safe to use.
  • ● The CRT device’s battery typically lasts 5–10 years and will need to be replaced once depleted.

For further information, please consult your attending doctor or cardiologist. 

The above information is for reference only. As each patient’s condition may vary, please consult your doctor for individual assessment and advice.