Cardiac Resynchronisation Therapy (CRT) -
What is Cardiac Resynchronisation
CRT devices are used to treat heart failure and
can be a permanent pacemaker with or without
an Implantable Cardioverter Defibrillator (ICD).
They improve overall function of the heart and
make the main pumping chambers of the heart
beat at the same time.
If you have an abnormality in the electrical pathway
of your heart which upsets its regular beating,
a pacemaker can be inserted to produce
electrical impulses to make your heart chambers
pump more regularly. CRT-Pacemakers work like
traditional pacemakers but are more advanced.
In heart failure the left side of the heart may
not pump at the same time as the right, meaning
the two sides of the heart lose their coordination.
CRT-pacemakers have an additional
lead which helps restore the hearts coordination
and make the heart beat more efficiently.
It is important to note that any device is NOT a
replacement for your heart failure medication.
How is a CRT- Pacemaker fitted?
This procedure is normally performed under a local
anaesthetic. You will be sedated to make sure
you are relaxed and sleepy. A small box is placed
under the skin in your chest, just below your collar
bone. This is connected to small leads which
pass through a vein into three sites in the heart.
The implant should take between 2 – 4 hours,
sometimes longer and you will need to lie quite
flat for this time. Any stitches that may need to
be subsequently removed will be done at your GP
What happens after the CRT-Pacemaker
You will probably be allowed to go home the next
day, provided your CRT-Pacemaker is checked,
there are no complications and your doctor assesses
it is safe. It is important that you tell the
nurse immediately if you have any pain or discomfort.
The wound should be kept dry until it has
fully healed, although it is fine to have a bath or
You will be given a CRT-Pacemaker identity card
with details of the make and model of your CRTPacemaker.
This card should be kept with you at
all times. If you require further treatment in the
future it is essential that you show the card to the
medical professional who is treating you.
Are there any risks associated with the procedure?
There are some small risks associated with having
a CRT-Pacemaker fitted. Generally the most
common risks are:
♥ A small risk of infection, bleeding and
bruising to the pacemaker site.
♥ A small risk of lead displacement – the
pacemaker lead can move and would
then need repositioning
♥ A small risk of perforation of the lung
during the procedure
Occasionally after a CRT implant patients may
experience chest twitching caused by irritating a
nerve near some of your breathing muscles. This
can usually be corrected by resetting the CRTPacemaker.
Occasionally when implanting CRT-Pacemakers it is not possible to position the extra lead. If this
happens the doctor will discuss other options for
placing the lead with you which would involve another
Will I feel anything different?
You should not be aware of the CRT-Pacemaker
working but occasionally people are conscious of
their heart beating faster, particularly if you had
a very slow heart rhythm before the pacemaker
The CRT-Pacemaker will not usually stop the heart
from speeding up so if you had fast palpitations
before then they may continue. If this occurs the
palpitations are usually treated by medication.
The CRT-Pacemaker will be set to enable your own
heart to work as much as possible on its own and
will only come in if your heart rhythm slows down
to a certain level. It works on ‘demand’.
What about driving?
There will be some restrictions but these will vary
depending on why you have had your CRT-Pacemaker
fitted. You can access DVLA guidelines on:
You must inform the DVLA that you have had a
CRT-Pacemaker implanted. You must also make
sure that you inform your insurance company.
You should always contact your ICD centre
if you think you have had a shock. Any
further questions please contact the Arrhythmia Nurse Specialist on 01273 696955 Ext 4071 or the cardiac department at RSCH on 01273 696955
Courtesy of Arrhtyhmia Alliance. Registered Charity No. 1107496 ©2010