Cardiac Resynchronization Therapy: How It is Done?

July 26, 2022 | 3 minutes read time

The heart is a four-chambered, vital organ that pumps blood throughout the body. The upper chambers (atria) receive the blood from the veins while the lower chambers (ventricles) pump it through the arteries to the rest of our body.

What makes the heart pump?

The electrical system governs the contraction and relaxation of the atria and ventricles. This electrical impulse starts at the Sino-atrial (SA) node, located in the right atrium. The SA node is the heart’s natural pacemaker. The impulse then travels through the atria, atrioventricular (AV) node, and ventricles.

That’s how a normal electrical conduction system works. Dr. Vanita, a top cardiologist in the country, explains why and who may need cardiac resynchronization therapy (CRT).

Abnormality In the Electrical Conduction System

In cardiomyopathy patients, the electrical conduction system does not work efficiently. One of the most common abnormalities found in cardiomyopathy patients is the delay of electrical conduction in the left ventricle.

This dyssynchrony weakens the heart’s ability to pump blood efficiently. In patients with existing heart conditions, it can lead to heart failure as well. Such individuals may benefit from CRT cardiology, Dr. Vanita suggests. The procedure is sometimes also referred to as bi-ventricular pacemaker surgery. How Does CRT Work?
The main purpose of cardiac resynchronization therapy is to overcome the electrical conduction system’s delay and restore the normal pumping function of the heart. It does so through a biventricular pacemaker or CRT device.

The CRT device is attached with three leads used to stimulate the ventricles.

How Is It Done?

There are two ways to perform a CRT procedure.

In the epicardial cardiac resynchronization therapy method:

• • The cardiologist connects each lead to the left ventricle, right ventricle, and right atrium. The leads are inserted through a vein inside the chest.
• • They place the pulse generator part of the CRT device in the patient’s upper chest.
• • The usual recovery time is 24 hours.

In the endocardial CRT method:

• • The surgeon connects the leads to the chambers using a fluoroscopy machine.
• • They place the pulse generator in the lower abdomen region. .
• • The usual recovery time is 3-5 days.

It’s normal to feel slight discomfort in the first 48 hours. However, if the discomfort is accompanied by persistent pain, your cardiologist will address it. The patients are constantly observed via Holter monitor, telemetry monitor, telephone monitoring, and follow-up appointments even after being discharged.

Who Needs CRT?
The following individuals may require cardiac resynchronization therapy:

• • People with severe heart failure symptoms, such as shortness of breath and reduced exercise tolerance despite medications.
• • People with cardiomyopathy (a condition where patients develop enlarged or weakened heart muscle).
• • People who have left bundle branch block (LBBB), which is problems with the heart’s electrical conduction system.

Only a cardiologist like Dr. Vanita can give you a formal diagnosis and recommend CRT if needed.