Cardiac Resynchronization Therapy- Defibrillator(CRT-D) Pre Procedure Instructions-TUKH

 

A Cardiac Resynchronization Therapy-Defibrillator (CRT-D) is a device that that monitors and treats heart arrhythmias. The goal is also to help improve weak heart pumping function.  Weak pumping function can have multiple causes and may also be referred to as heart failure.

 Heart failure is a condition in which the heart muscle has become weak. It can be caused by an electrical problem, a blood flow problem or other chronic conditions.  Your Doctor can discuss these with you.   With heart failure the chambers of the heart may not be in sync so the bottom chambers of the heart (ventricles) lose some of their ability to pump effectively. This can make heart failure worse.

 The CRT-D has two basic parts:

1. Pulse generator (which houses the battery and pacemaker/defibrillator)
2. Leads, there are usually 2 or 3 wires that connect to different chambers of the heart. 

The leads have 2 purposes:

1. Allow the device to “see” heart beats and carry the electrical impulses (make the heart beat or “pace”). 
2. Shock to the heart if cardiac arrest occurs (defibrillate).

 

The “defibrillator” function can prevent you from dying from cardiac arrest (a life-threatening heart rhythm known as ventricular tachycardia and/or ventricular fibrillation).

• It is capable of pacing and/or shocking the heart back to normal rhythm when a rapid life-threatening heart rhythm occurs.  
• When appropriate, the defibrillator will first try to “pace” your heart out of dangerous ventricular rhythms to avoid a shock if possible. 
• If rapid pacing is not successful, the CRT-D will deliver a shock to restore regular rhythm. 
• A defibrillator itself will not make you feel better, but the pacemaker function should help with symptoms of shortness of breath and fatigue related to slow heart rates or the chambers not beating in sync. 

This device is also called a biventricular defibrillator (defibrillator with leads in both ventricles) or resynchronization defibrillator (as it is intended to re-synchronize the heart chambers and improve pumping). 

 

The “pacemaker” function in your CRT-D is used make your heart chambers beat in sync.   The leads allow the device to “see” heart beats and can send electrical signals(pacing) to the different chambers in the heart (atria and ventricles). 

• When all of the chambers are in sync the heart pumps better. 
• The goal is to pace the ventricles as close to 100% of the time as possible or synchronize the ventricles (pumping chambers) of the heart with every beat.
• This can improve some symptoms of heart failure. 

 

CRT-D won’t replace other heart failure treatments. It is part of a complete heart failure treatment plan. CRT-D helps a weakened heart do a better job of pumping blood out of the heart with each beat so more blood and oxygen goes to the rest of your body. This can decrease heart failure symptoms and improve survival.  Not everyone with heart failure will benefit from a CRT-D. The CRT-D will improve symptoms in about 2 out of 3 people who get it and may require several adjustments to make the settings optimal for you and your body.

 

Your CRT-D is implanted by an electrophysiologist; a cardiologist specializing in the electrical system of the heart.  Your CRT-D will be implanted in a room in the electrophysiology laboratory.

 

Who do I contact if I have questions? 

Call Mid-America Cardiology electrophysiology nurse triage line at 913-588-9757. 

Richard & Annette

Bloch Heart Rhythm Center

“Center for Excellence in Cardiac Device Management” 

 

This information is meant to serve as a resource to you and your family. It is not meant to be all inclusive. The members of the Richard and Annette Bloch Heart Rhythm Center at Mid-America Cardiology, 913-588-9600, will be glad to answer any questions you may have about this booklet or your procedure.