CRT-D

CRT-D or CRT-P is a procedure to implant a device (biventricular pacemaker) in the chest that sends electrical signals to both lower chambers of the heart, to make heart chambers squeeze in a more organized and efficient way, which improves the pumping of blood out of the heart.

CRT-D - Overview

CRT-D (Cardiac Resynchronization Therapy Defibrillator) is also known as CRT-P (Cardiac Therapy Defibrillator Pacemaker) with an implantable cardioverter-defibrillator.

It is a procedure to implant a device (biventricular pacemaker) in the chest that sends electrical signals to both lower chambers of the heart, to make heart chambers squeeze in a more organized and efficient way, which improves the pumping of blood out of the heart.

CRT-D is a treatment to reduce symptoms and lower the risk of heart failure, in which heart muscles weakens and may not be able to pump out enough blood to support the body. This can be worsened if heart chambers aren’t in synchronization with each other.

CRT-D - Symptoms

The patient has moderate to severe heart failure symptoms.
Pumping chambers (ventricles) of the heart are not working together.
Some investigations show that the heart is weak and enlarged.
Medicines and lifestyle changes are not working well enough to control heart failure.

CRT-D - Pre-Procedure

Overnight fasting is required before the procedure.
The patient may need to stop blood-thinning medicines, anti-inflammations, herbal supplements, several days before the procedure.
If a patient is diabetic, the doctor will make some changes in the doses a few days before the procedure.

CRT-D - During Procedure

This procedure may take 4 to 5 hours.
The doctor will give medication to make the patient comfortable and drowsy.
The doctor will numb the area where the device will be placed, below the collar bone by using local anesthesia.
A small incision will be made in the upper chest.
Three leads (thin insulated wires) will be guided through a vein into the heart.
Leads will be connected to the implanted heart device.
The doctor will test the device and program the settings in the device.
The device will be inserted beneath the skin and incisions will be closed.

CRT-D - Post-Procedure

The patient may need to limit activities such as weight lifting, straining, and stretching for the first 6 weeks after the procedure.
The patient should inform his/her doctor if feels, fever, redness, soreness, discharge, bleeding, or swelling.
Patients need to stay away from the devices that have strong magnetic fields, such as, electrical generators and appliances like microwaves.
The device’s battery will last for 4 to 8 years. After the duration, contact with doctor accordingly.

CRT-D - Risk & Complications

Bleeding
Swelling or bruising in the procedure area
Injury to blood vessels
Collapsed lungs (pneumothorax)
Compression of the heart due to fluid build-up in the sac surrounding the heart (cardiac tamponade)
Failure of the device
Shifting of device parts, which could require another procedure.