Cardiac Resynchronization Therapy (CRT) is a specialized treatment designed to help the heart beat in a more coordinated and efficient way. It is mainly used for people with heart failure whose heart’s electrical system is not functioning properly. In cardiac resynchronization therapy, a small device is implanted to correct abnormal heart rhythms and improve heart pumping strength. This treatment helps reduce symptoms like fatigue, breathlessness, and swelling. CRT is considered a reliable option when medications alone are not enough.
What Happens During the CRT Procedure?
1. Pre-procedure preparation
- The patient is admitted to the hospital, and basic tests such as ECG, blood tests, and imaging are completed.
- An IV line is placed to give fluids and medications.
- The chest area is cleaned and sterilized to prevent infection.
2. Anesthesia and sedation
- Local anesthesia is given near the collarbone to numb the area.
- Light sedation is provided so the patient remains relaxed but awake.
3. Making a small incision
- A small 3–5 cm cut is made below the collarbone (usually on the left side).
- This opening gives access to the vein through which the CRT leads will be placed.
4. Guiding the leads into the heart
- Using X-ray guidance (fluoroscopy), the doctor gently inserts thin wires called “leads” through a vein.
- The leads are positioned in three specific heart chambers:
- Right atrium
- Right ventricle
- Left ventricle (through a coronary vein)
- Right atrium
- These leads help synchronize the heart’s electrical activity.
5. Placing the CRT device
- After placing the leads correctly, the doctor creates a small pocket under the skin.
- The CRT device (similar to a small matchbox) is placed inside this pocket.
- The device is then connected to all three leads securely.
6. Testing the device
- The doctor activates the CRT device to check if the heart is responding correctly.
- The pacing levels are adjusted to ensure the left and right ventricles beat in a coordinated manner.
- This step ensures proper synchronization before closing the incision.
7. Closing the incision
- The small cut is closed using stitches or medical glue.
- A bandage is applied to protect the area and promote healing.
8. Immediate post-procedure monitoring
- The patient is shifted to a recovery room for observation.
- Heart rhythm, BP, and oxygen levels are closely monitored.
- A chest X-ray is done to confirm correct lead placement and check for any complications.
9. Discharge and follow-up
- Most patients can go home in 24–48 hours.
- Follow-up visits are scheduled to check wound healing and adjust the device settings for optimal performance.
- Patients are advised to avoid heavy lifting and arm movements on the implanted side for a few weeks.
How Can CRT Help?
Benefits of Cardiac Resynchronization Therapy
- Cardiac resynchronization therapy helps improve heart pumping efficiency by coordinating the contraction of the left and right ventricles.
- It reduces symptoms such as breathlessness, fatigue, and swelling, helping patients perform daily activities with ease.
- Cardiac resynchronization therapy can lower the risk of hospitalization due to heart failure.
- It can enhance overall quality of life through better blood circulation.
- In some patients, CRT can improve heart function over time.
- Cardiac Resynchronization Therapy Devices also help monitor and manage abnormal heart rhythms continuously.
Who Can Get CRT?
Eligibility for Cardiac Resynchronization Therapy
People who qualify for cardiac resynchronization therapy generally have moderate to severe heart failure.
- Those with weakened heart pumping function, especially if the left ventricle is enlarged or working poorly.
- Patients whose ECG shows delayed electrical activity, such as left bundle branch block.
- Individuals who continue to have symptoms even after receiving the best medical therapy.
- Those meeting the Indications for Cardiac Resynchronization Therapy based on cardiologist evaluation.
- Patients with reduced ejection fraction and difficulty performing daily physical tasks may benefit from CRT.
CRT Indications
When Is Cardiac Resynchronization Therapy Recommended?
- Significant widening of the QRS complex on ECG indicating delayed electrical conduction.
- Persistent heart failure symptoms despite optimized medication.
- Reduced ejection fraction showing poor heart pumping ability.
- Presence of left bundle branch block requiring cardiac resynchronization therapy support.
- Use of Cardiac Resynchronization Therapy Devices to correct heart rhythm abnormalities.
- Patients with moderate to severe heart muscle weakness where cardiac resynchronization therapy can improve function.
Understanding the Cost of CRT
- The cardiac resynchronization therapy cost mainly depends on the type and technology of the CRT device used.
- A significant part of the total expense comes from the CRT device itself, which varies based on advanced features and battery life.
- The overall cardiac resynchronization therapy cost may also include hospital stay charges, operating room fees, and medical supplies.
- Pre-procedure tests such as ECG, ECHO, blood work, and imaging contribute to the total cost.
- The final cardiac resynchronization therapy cost includes care from the best cardiologist, electrophysiologist, and surgical team.
- Post-procedure expenses like device programming, monitoring visits, and follow-up care also influence the total cost of the treatment.
Conclusion
Cardiac resynchronization therapy is a proven and effective solution for patients with heart failure and electrical conduction problems. By improving the heart’s coordination, it helps reduce symptoms and enhances overall well-being. With cardiac resynchronization therapy placed carefully under medical guidance, many patients become more active and feel healthier over time. This treatment offers hope, better quality of life, and a path toward long-term stability. If symptoms continue despite medication, seeking timely consultation can make a meaningful difference.
