Cardiac Resynchronization Therapy Device (CRT-D)

A Cardiac Resynchronization Therapy Device with Defibrillator (CRT-D) is an advanced medical device implanted in the chest to help manage heart failure and other serious heart conditions. A CRT-D combines cardiac resynchronization therapy and defibrillation to improve heart function, prevent life-threatening arrhythmias, and enhance the quality of life for individuals with weakened heart muscles.

Signs & Symptoms

 Symptoms suggesting CRT-D may be necessary often relate to heart failure and arrhythmias:

• Persistent shortness of breath.
• Fatigue or weakness.
• Swelling in the legs, ankles, or abdomen.
• Irregular or rapid heartbeat.
• Difficulty performing everyday activities due to tiredness.
• Dizziness or fainting.

Causes

Conditions that may lead to CRT-D consideration include:

• Coronary artery disease (CAD): Blocked arteries can weaken the heart.
• Cardiomyopathy: Enlarged or damaged heart muscle.
• Congenital heart defects: Heart abnormalities present at birth.
• Electrolyte imbalances: Irregular levels of potassium or calcium.
• Previous heart attack: Damage from a heart attack can disrupt electrical signals in the heart.

When to seek medical attention?

 If you experience any of the following, you should consult a cardiologist:

• Persistent chest pain or pressure.
• Frequent dizziness or fainting spells.
• Difficulty breathing when lying down.
• Swelling in the legs or abdomen that worsens.
• Irregular heartbeats that feel like flutters or pounding.

Risk Factors

 Risk factors that may increase the likelihood of needing a CRT-D device include:

• High blood pressure.
• Diabetes.
• Family history of heart disease.
• Obesity.
• Smoking.
• Excessive alcohol use.

Diagnostic & Test

Several tests help determine if a CRT-D device is appropriate:

• Echocardiogram (Echo): Assesses heart muscle function and synchronization.
• Electrocardiogram (ECG or EKG): Monitors electrical activity for irregularities.
• Stress Test: Evaluates heart performance under stress.
• Blood tests: Check for cardiac enzymes and other indicators of heart health.
• Cardiac MRI or CT scan: Provides detailed images of the heart's structure.

Treatment Procedure

 CRT-D implantation is a minimally invasive surgical procedure:

• Preparation: Performed under local anesthesia, with mild sedation.
• Incision and lead placement: A small incision is made near the collarbone, and leads are guided to the heart's ventricles.
• Device connection: Leads are connected to the CRT-D device, which is inserted in a small pocket created under the skin.
• Programming: The device is programmed to manage heart rhythms effectively.

Do’s & Don’ts

 Do’s

• Follow-up appointments: Keep regular check-ups to monitor device performance.
• Limit arm movement initially: Avoid strenuous arm activities for several weeks.
• Take prescribed medications: To support heart health and prevent complications.
• Report symptoms: Inform your doctor of any unusual symptoms, like fainting or dizziness.

 Don’ts

• Avoid strong magnets or electrical fields: These can interfere with the CRT-D.
• Refrain from high-impact activities: Avoid sports that could damage the device.
• Skip scheduled battery checks: The battery will need periodic monitoring and eventual replacement.

FAQ’s For Cardiac Resynchronization Therapy Device (CRT-D)