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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Cardiac Resynchronization Therapy (CRT) in Cardiology
Introduction
Cardiac resynchronization therapy (CRT) is a treatment designed to improve the heart's efficiency in patients with heart failure and electrical conduction abnormalities. It involves the placement of a specialized pacemaker that helps synchronize the contractions of the heart’s ventricles.
Who Needs CRT?
CRT is primarily recommended for patients with: - Heart failure with reduced ejection fraction (HFrEF) (≤35%) - Wide QRS complexes (≥130 ms), especially with left bundle branch block (LBBB) - Persistent symptoms despite optimal medical therapy
How Does CRT Work?
- A small device (CRT-P pacemaker or CRT-D defibrillator) is implanted under the skin.
- Leads are placed in the right atrium, right ventricle, and a coronary vein for the left ventricle.
- These lead placements help synchronize the contraction of the heart’s chambers, enhancing cardiac output and reducing heart failure symptoms.
Benefits of CRT
- Improves symptoms of heart failure (less fatigue, breathlessness)
- Enhances quality of life and exercise capacity
- Reduces hospitalizations due to heart failure exacerbations
- Prolongs survival in selected patients
Risks and Considerations
While CRT has many benefits, it is not suitable for every patient. Possible risks include: - Lead placement complications - Infection and bleeding at the device site - No response in some patients (non-responders)
Conclusion
CRT is a well-established therapy that significantly improves outcomes in carefully selected heart failure patients. If you have heart failure with conduction abnormalities, discuss CRT as a potential treatment with your doctor.
Source recommendations
1. American Heart Association Guidelines on Heart Failure
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
- https://www.heart.org/en/health-topics/heart-failure
- https://professional.heart.org/en/guidelines-and-statements
- https://www.heart.org/en/professional/quality-improvement/get-with-the-guidelines/get-with-the-guidelines-heart-failure
- https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx
2. European Society of Cardiology Guidelines on Cardiac Pacing
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiac-Pacing-and-Cardiac-Resynchronization-Therapy
- https://academic.oup.com/eurheartj/article/42/35/3427/6358547
- https://pubmed.ncbi.nlm.nih.gov/34455430/
- https://academic.oup.com/eurheartj/article/34/29/2281/401445
- https://pubmed.ncbi.nlm.nih.gov/23801827/
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