Cardiac Resynchronization Therapy (CRT) is an advanced device treatment used for patients with severe heart failure and weak heart pumping function. In some heart failure patients, the right and left sides of the heart do not beat in a coordinated manner because of electrical conduction abnormalities. This uncoordinated beating reduces the efficiency of the heart and worsens symptoms such as breathlessness, tiredness, swelling of the legs, reduced exercise capacity, and repeated hospital admissions. A CRT device helps the heart chambers beat together in a synchronized manner, improving overall heart function.
CRT is commonly recommended for patients with reduced heart pumping function (low ejection fraction), persistent heart failure symptoms despite medications, and specific ECG abnormalities such as bundle branch block. These patients may continue to experience severe symptoms even while taking optimal medical treatment. Detailed evaluation including ECG, echocardiography, and heart failure assessment helps determine whether a patient is suitable for CRT therapy.
The procedure is performed in a specialized cardiac catheterization laboratory or operation theatre under local anesthesia and mild sedation. Similar to pacemaker implantation, thin insulated wires called leads are inserted through veins and guided into different chambers of the heart under X-ray guidance. Unlike a standard pacemaker, a CRT device usually requires an additional lead placed on the left side of the heart through a specialized vein. The leads are then connected to the CRT device, which is implanted under the skin in the upper chest area.
The CRT device continuously coordinates the timing of heart chamber contractions so that both sides of the heart pump together more efficiently. This synchronized pumping improves blood circulation throughout the body and reduces the workload on the weakened heart. In some patients, the device may also include a defibrillator function (CRT-D) to protect against dangerous life-threatening heart rhythms. The procedure usually takes a few hours, and patients are generally discharged after a few days depending on their condition and recovery. Mild discomfort or swelling near the implantation site may occur initially. Patients are advised to avoid excessive arm movements for a few weeks to allow proper healing of the leads and device pocket.
CRT therapy has significantly improved the treatment of advanced heart failure in selected patients. Many patients experience improvement in breathing, exercise capacity, energy levels, and overall quality of life after implantation. CRT can also help reduce hospital admissions related to heart failure and may improve long-term survival. The device battery usually lasts around 7 to 10 years, after which the generator can be replaced through a simpler procedure if needed. Regular follow-up and device monitoring are important to ensure optimal functioning and long-term benefit.
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