Cardiac Resynchronization Therapy (CRT) or Biventricular Pacing

Cardiac resynchronization therapy (CRT) is a treatment that involves biventricular pacing to help coordinate the beating of the heart’s ventricles. It can be offered as a biventricular pacemaker (CRT-P) or defibrillator (CRT-D)
In individuals with heart failure, the heart’s electrical system can become disrupted, causing the ventricles to contract at different times. This can lead to reduced cardiac output and symptoms such as shortness of breath and fatigue.
Cardiac Resynchronization Therapy involves placing three leads into the heart: one in the right atrium, one in the right ventricle, and one around the left ventricle. The leads send electrical signals to the heart that help the ventricles contract at the same time, improving the heart’s pumping efficiency and reducing symptoms.
The overall response rate and improvement with biventricular pacing is about 70%, but can be higher or lower depending on a number of factors including the underlying cause, the baseline ECG, other arrhythmias present, and the severity of the patient’s heart failure. Clinical trials have demonstrated that biventricular pacing can improve symptoms, reduce hospitalizations, and improve survival rates in certain patients with heart failure. In particular, studies have shown that biventricular pacing can improve the heart’s pumping efficiency, which can lead to improved exercise capacity and quality of life.
Fig 66 Biventricular ICD بطارية تنسيق عمل البطينين1
However, it’s important to note that not all patients with heart failure are good candidates for biventricular pacing. Therefore, it’s important to consult with a qualified electrophysiologist to determine if a particular patient meets the specific criteria to make biventricular pacing an appropriate treatment option. Furthermore, it is important to note that while the risks associated with Cardiac Resynchronization Therapy are generally low, they should be carefully
considered before undergoing the procedure. Finally, Cardiac Resynchronization Therapy is often used in conjunction with other therapies such as medication and lifestyle changes to achieve best heart failure treatment.