Cardiac Resynchronization Therapy (CRT)
Cardiac Resynchronization Therapy (CRT) is an advanced device-based treatment used for selected people with heart failure whose heart chambers do not contract in a coordinated way. Also known as biventricular pacing, CRT uses carefully timed electrical impulses to help the lower chambers of the heart beat more synchronously.
CRT may be considered when heart failure continues despite appropriate medical treatment and when tests such as an echocardiogram and ECG show features that may make a patient suitable for the therapy. Eligibility depends on several factors, including heart pumping function, symptoms, heart rhythm and electrical conduction pattern.
How Does CRT Work?
A CRT device is implanted under the skin of the chest and connected to the heart through leads. The device delivers coordinated electrical signals to the ventricles, helping them contract in a more synchronized manner.
There are two common types of CRT devices:
- CRT-P: Cardiac resynchronization therapy with a pacemaker.
- CRT-D: Cardiac resynchronization therapy combined with an implantable cardioverter-defibrillator (ICD), which can also detect and treat certain dangerous heart rhythms.
The choice between CRT-P and CRT-D depends on the patient's heart condition, risk profile and clinical assessment.
Who May Benefit From CRT?
CRT is not suitable for every person with heart failure. A cardiologist evaluates factors such as:
- Left ventricular ejection fraction (LVEF)
- Heart failure symptoms and functional status
- ECG findings, including QRS duration and left bundle branch block (LBBB)
- Heart rhythm
- Response to guideline-directed medical therapy
- Overall health and other medical conditions
Current heart-failure guidelines identify specific groups with reduced ejection fraction and electrical conduction abnormalities who may benefit from CRT. The exact indication should be determined by a qualified cardiologist after a complete evaluation.
What Happens During CRT Implantation?
CRT implantation is generally performed as a minimally invasive procedure. After appropriate anesthesia or sedation, the device is placed beneath the skin of the chest, while leads are guided through a blood vessel toward the heart using imaging guidance.
The procedure commonly takes a few hours, although the duration can vary depending on the patient's anatomy, device type and clinical circumstances. After implantation, the device is programmed and checked to ensure appropriate function.
Benefits of Cardiac Resynchronization Therapy
For appropriately selected patients, CRT may help:
- Improve coordination of the heart's ventricular contractions
- Improve heart function
- Reduce symptoms associated with heart failure
- Improve quality of life
- Reduce the likelihood of hospitalization for heart failure in appropriate patients
- Support better day-to-day functional capacity
The potential benefits vary between individuals, and CRT should be considered as part of a comprehensive heart-failure treatment plan rather than as a replacement for prescribed medical therapy.
Why Choose Specialist Cardiac Care?
CRT requires careful patient selection, device implantation and ongoing follow-up. A specialist cardiac team can assess your symptoms, ECG, echocardiogram and other clinical findings to determine whether CRT is appropriate for your condition.
If you or a family member has heart failure and has been advised to consider a pacemaker, ICD or CRT, consult a qualified cardiologist to understand the available treatment options.