Cardiac Insufficiency (CRT)
Implantation of Devices to Treat Cardiac Insufficiency
Severe forms of heart failure are treated with the methods of cardiac resynchronization therapy (CRT), cardiac contractility modulation (CCM), and baroreceptor stimulation.
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Cardiac Resynchronization Therapy (CRT)
What is a device for cardiac resynchronization therapy?
Patients with a severely limited pumping function of the heart and an asynchronous contraction of the two heart chambers benefit from the implantation of a device for cardiac resynchronization. The time-delayed contraction of the left and the right ventricle leads to a further deterioration of the cardiac performance and the clinical symptoms if the pumping performance of the heart is already limited.
Restoring a simultaneous contraction of the left and right ventricle (cardiac resynchronization) by stimulation of the right and the left ventricle leads to an improvement of the heart’s pumping function over time. As a result, symptoms of cardiac failure, such as limited physical performance capability, can improve.
How are devices for cardiac resynchronization therapy implanted?
CRT systems (devices for cardiac resynchronization therapy) are implanted in a similar way as a pacemaker system or a defibrillator. The implantation is performed under local anesthesia and the additional administration of sedatives. The CRT device is implanted below the clavicle into a tissue pocket under the skin or between the chest muscles. Similar to the pacemaker or defibrillator implantation, one or two leads are advanced to the heart through veins leading to the heart and are anchored at the cardiac membrane. In addition, another lead is placed in a coronary vein that runs along the surface of the left ventricle.
These systems can be used as pure pacemaker systems (CRT-P) or with additional defibrillator functions (CRT-D).
The follow-up of the CRT systems take place at fixed intervals (every 4 to 6 months) at our pacemaker outpatient department or at a cardiologist's practice.