Key points about CRT

• CRT may improve symptoms and quality of life for certain heart failure patients. 

• It involves implanting a device that helps synchronize heartbeats. 

• Candidates typically have reduced ejection fraction and electrical conduction delays. 

• The procedure is generally well tolerated and recovery is usually short. 

• Follow-up care includes device checks and heart failure management. 

Overview of cardiac resynchronization therapy 

Cardiac resynchronization therapy is a specialized form of pacemaker therapy for heart failure patients whose heart chambers are not beating in a coordinated way. It helps the heart pump more effectively by synchronizing contractions of the ventricles. 

Candidates for CRT 

CRT is generally considered for patients who: 

• Have symptomatic heart failure (typically NYHA class II–IV). 

• Have a left ventricular ejection fraction (LVEF) of 35% or less. 

• Show a prolonged QRS duration (often ≥130–150 ms) with left bundle branch block pattern. 

• Are already receiving guideline-directed medical therapy without sufficient symptom relief. 

Preparation for CRT 

• Patients may undergo imaging (such as echocardiogram or cardiac MRI) to assess heart function. 

• An ECG is used to evaluate electrical conduction. 

• Blood tests and medication review are part of the pre-procedure workup. 

• Instructions will be given to stop certain medications or fast before the procedure. 

Recovery from CRT 

• Most patients are monitored overnight and discharged the next day. 

• Minor discomfort at the implant site is common for a few days. 

• Physical activity may be limited for several weeks to allow the leads to settle. 

• Follow-up visits are scheduled to check device function and heart rhythm. 

• Improvement in symptoms may take weeks or months as the heart adapts. 

Risks for CRT 

While CRT is generally safe, possible risks include: 

• Infection or hematoma at the device site. 

• Lead displacement requiring repositioning. 

• Rare complications like pneumothorax, cardiac perforation, or arrhythmia. 

• Non-response to CRT—some patients may not experience symptom improvement. 

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