Cardiac Resynchronization Therapy (CRT)

Cardiac resynchronization therapy (CRT) involves the implantation of a pacemaker, an electronic device used to treat congestive heart failure by stimulating the left and right lower chambers of the heart to beat appropriately and efficiently. The procedure to place the pacemaker involves a small incision made in the chest, above the collarbone.


1.    Alleviates the symptoms of congestive heart failure, which is when the heart beats more weakly than normal, preventing adequate blood from being pumped to the different parts of the body. The pacemaker will help the lower chamber of the hearts beat more efficiently in rhythm with each other.

2.    Improves survival, quality of life, heart function, and the ability to exercise.

3.    Reduces hospital stays in patients with severe congestive heart failure

There are two types of pacemakers that can improve heart function and blood circulation:

1.    A regular cardiac resynchronization therapy pacemaker or CRT-P.

2.    A cardiac resynchronization therapy defibrillator, or CRT-D, can detect when an arrhythmia is life-threatening and automatically shock the heart back into a normal rhythm. Doctors normally recommend the cardiac resynchronization therapy defibrillator (CRT-D), but the final decision on the appropriate device will depend on the individual patient.

  1. Avoid food and water for at least eight hours before the procedure.
  2. Let your doctor know about all medication that you are taking as some may need to be stopped before the procedure.

1.    The patient will receive intravenous fluids and medication.

2.    During the procedure the patient’s vital signs and blood pressure will be monitored.

3.    The patient will be given a sedative and/or anesthesia from the anesthesiologist so they are asleep during the procedure. A local anesthetic will be administered before the lead (or leads) is placed. This is a small wire that is inserted into a major vein near your collarbone. Leads are attached to the muscles of the heart in the appropriate locations and are connected to the pulse generator.

4.    When the device is placed the doctor will program it to stimulate the heart as appropriate for the patient.

5.    The placement of the cardiac resynchronization therapy (CRT) device takes approximately two to four hours.

1.    The patient will be moved to the Cardiac Care Unit (CCU) for one night for close observation and then will be moved to a regular inpatient room for an additional one to two nights to ensure that the cardiac resynchronization therapy (CRT) device is working properly.

2.    You may experience some pain and swelling in the area where the device was placed.

3.    You will be asked to avoid raising the arm above the shoulder on the side of the cardiac resynchronization therapy (CRT) implantation, strenuous activity and heavy lifting for about one month after the surgery.

4.    During your regular check-ups, your doctor will check the battery in your device, which should last up to 5-10 years, depending on how much it is used. The replacement of batteries is done much more easily than the initial placement of the device.

  1. Bleeding or hematoma, and infection where the cardiac resynchronization therapy (CRT) device was implanted.
  2. Allergic reaction to the medications used during the procedure.
  3. Damage to blood vessels.
  4. Collapsed lung.
  5. Bleeding in the pericardium.
  6. Stroke, heart attack, or other serious complications, which are uncommon.
  7. Death (rare).
Let your doctor know if you develop problems, such as:
  1. Bleeding, swelling, or increased pain at the implantation site
  2. Fever
  3. Dizziness or fainting
  4. Chest pain
  5. Difficulty breathing


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