Cardiac Resynchronisation Therapy

Cardiac resynchronisation therapy is the surgical implantation of a CRT device under your skin. This pacemaker device monitors your heart and treats abnormal heart rhythms.

The CRT pacemaker has a battery and three wires that are contained in a small metal-covered box. The three wires are connected to the ventricles on both sides of your heart. They send electrical signals to your left and right ventricles to make them pump together, called biventricular pacing.

Cardiac resynchronisation therapy uses a biventricular pacemaker to enable both sides of your heart to beat together. This is called resynchronisation.

Most pacemakers only have one or two wires to the right side of your heart. A CRT pacemaker has an extra wire that is placed into the left side of your heart. The pacemaker monitors your heart rate to detect heart rate irregularities. The three wires send tiny electrical signals to both lower chambers of your heart, called the left and right ventricles. These signals cause your ventricles to contract in a more coordinated way. This improves the pumping of blood out of your heart and makes you feel less breathless and fatigued.

You may also have an implantable cardioverter defibrillator (ICD) to help fix serious heart rhythm problems. Some CRT devices contain an implantable cardioverter-defibrillator (ICD). The ICD delivers a controlled electrical shock, called defibrillation, if your heart rhythm becomes dangerously fast to try to bring it back to normal. The electrical shock is initially small, but if that fails a larger shock is sent from the ICD.

Your CRT device may be inserted as a day case or overnight procedure. It can take three to five hours.

You are usually awake during the procedure and are given sedative drugs and painkillers to help you relax and ease any pain. The area where your CRT pacemaker will be implanted is numbed with a local anaesthetic injection under your skin.

During surgery, your doctor makes a small cut and creates a pocket under your skin just below your collarbone. This pocket holds the wires and CRT device.

Your cardiologist puts CRT wires in your large vein and feeds them to your heart using X-ray guidance to ensure they are in the right place on both sides of your heart. They then test the wires with an electric pulse. When the leads are placed and working correctly, they are attached to your CRT pacemaker and the pacemaker is placed in the pocket. The incision is then closed.

After the insertion of a CRT device, you will spend time in the recovery area.

Your cardiologist will check the settings on your CRT device and adjust them if needed.

You may have pain relief if required.

When you leave the hospital, you should follow your healthcare team’s advice and attend your follow-up appointment. They may instruct you to limit lifting, straining, and stretching activities for the first six weeks.

You should keep your dressing clean and dry until you are told you can remove it and take a shower. Also keep an eye out for any signs of infection such as redness, soreness, discharge, bleeding, or swelling.

Your doctor will check your device regularly, typically every six months.

You should keep all electrical devices and magnets about six inches away from your CRT pacemaker as they can interfere with its function. Also, stay away from devices with strong magnetic fields such as electrical generators.

You should advise airport and healthcare professionals of your CRT pacemaker and carry your CRT pacemaker identification card with you. Metal wands used for airport screenings and MRI imaging tests should be avoided.

Your pacemaker battery will last for about six to ten years. Your doctor will tell you around six months before your battery runs out. They will arrange for a minor procedure to replace your CRT pacemaker.

Your doctor may suggest CRT if:

• you have moderate to severe heart failure symptoms and are at risk of fast, irregular, or life-threatening heart rhythms
• your heart ventricle chambers are not pumping together
• tests show that your heart is weak and enlarged
• medicines and lifestyle changes are not working well enough to control your heart failure.

The benefits of cardiac resynchronisation therapy are:

• it improves your heart’s efficiency and increases blood flow
• alleviates some heart failure symptoms, such as shortness of breath
• decreases hospitalisation and morbidity
• improves your quality of life.

All surgical procedures come with some risks. Risks specific to cardiac resynchronisation therapy depend on the type of implant used and your overall health.

Complications of cardiac resynchronisation therapy may include:

• infection
• bleeding
• pneumothorax - collapsed lung
• cardiac tamponade - fluid build-up in the sac surrounding the heart causes heart compression
• device failure
• device parts moving that could require another procedure.

The cost of a cardiac resynchronisation therapy will depend on your Ramsay hospital of choice.

You will receive a formal quotation price for your cardiac resynchronisation therapy following your consultation with one of our expert cardiologists. This formal quote will be valid for 60 days.

Ramsay is recognised by all major medical insurers, this treatment is covered by most medical insurance policies as long as they are deemed medically necessary by your doctor. We advise you to obtain written authorisation from your insurance provider. 

We have a number of finance options if you are paying for your treatment yourself with no deposit and benefit from flexible payment plans to suit your finances. Find out more about accessing healthcare with us here.