What is Cardiac Resynchronization Therapy (CRT)?

Cardiac Resynchronization Therapy (CRT) is an advanced treatment designed for patients with heart failure who have abnormal electrical conduction that leads to inefficient heart pumping. When the ventricles (the heart's main pumping chambers) do not contract in a coordinated manner, the heart's overall performance is diminished. CRT works by using a specialized pacemaker to restore a more synchronized and effective contraction pattern, thereby improving blood circulation and easing heart failure symptoms.

How Does CRT Work?

Device Components:

• Pulse Generator:
  The CRT device contains a pulse generator, which is implanted under the skin—typically in the upper chest. This generator acts as the “brain” of the system, sending electrical impulses to coordinate the heart’s rhythm.

• Leads/Electrodes:
  Three thin, insulated wires (leads) are usually placed strategically:

  • One in the right atrium

  • One in the right ventricle

  • One in a vein on the left side of the heart
    These leads facilitate precise timing in electrical stimulation of the heart muscle.

Mechanism of Action:

• Synchronization of Contraction:
  In many patients with heart failure, the ventricles contract out of sync, reducing the heart’s efficiency. CRT delivers timed electrical pulses to both ventricles, helping them contract at the same time.

• Enhanced Cardiac Output:
  By improving the synchronicity of ventricular contractions, CRT increases the amount of blood pumped with each heartbeat, improving overall cardiac output and alleviating symptoms such as fatigue and breathlessness.

 

Who is a Candidate for CRT?

CRT is primarily recommended for patients with moderate to severe heart failure who continue to experience symptoms despite optimal medical therapy. Typical criteria include:

• Reduced left ventricular ejection fraction (LVEF), indicating weakened heart muscle performance.

• A widened QRS complex on an electrocardiogram (ECG), which suggests a delay or abnormality in the electrical conduction through the ventricles.

• Persistent symptoms of heart failure, such as shortness of breath and reduced exercise capacity, despite receiving standard treatments.

 

The CRT Procedure

Pre-Procedure Evaluation:
Before undergoing CRT, patients typically receive a thorough evaluation, including imaging (echocardiography) and electrocardiography, to assess the degree of heart failure and electrical conduction abnormalities.

Implantation Process:

• Local Anesthesia and Conscious Sedation:
  The CRT device is implanted under local anesthesia. Patients are typically awake but sedated, ensuring comfort during the procedure.

• Insertion of Leads:
  Small incisions are made, often in the chest and near a vein in the shoulder or neck, to allow the placement of the leads. These leads are carefully advanced into the heart under X-ray guidance.

• Device Programming:
  Once the leads are in position, the pulse generator is connected and implanted just under the skin. The device is then programmed to deliver precise electrical impulses that coordinate the contractions of both ventricles.

• Post-Procedure Monitoring:
  After the procedure, patients are monitored in the hospital to ensure proper device function. Most patients recover quickly and can return home within a few days following implantation.

 

Benefits and Outcomes of CRT

Symptom Improvement:

• Patients often experience reduced symptoms of heart failure, including decreased shortness of breath and increased exercise tolerance.

Enhanced Quality of Life:

• By improving the efficiency of the heart’s contractions, CRT can lead to a better quality of life, reduced hospitalizations, and lower overall healthcare usage for individuals with advanced heart failure.

Potential for Cardiac Remodeling:

• Over time, CRT may facilitate a degree of reverse remodeling in the heart, leading to improvements in heart structure and function.

 

Why Choose Mahadev Heart Care?

At Mahadev Heart Care, Bangalore, our commitment is to offer the most advanced and patient-centric cardiac care available. With extensive expertise in heart failure management and device implantation, Dr. Mahadev Swamy and his dedicated team ensure that each patient receives personalized treatment tailored to their unique medical needs. Utilizing the latest technology and a multidisciplinary approach, we strive to help each patient achieve optimal heart performance and improve their overall quality of life.

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Cardiac Resynchronization Therapy (CRT) is a transformative treatment for patients with heart failure, designed to restore coordinated ventricular contractions and enhance cardiac output. With a proven track record of improving symptoms and quality of life, CRT represents a vital option for those who continue to struggle with heart failure despite conventional treatments.

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For further information on CRT or to discuss whether this therapy is right for you, please contact Mahadev Heart Care, Bangalore. Our expert team is here to guide you every step of the way toward better heart health.