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Cardiac Resynchronisation Therapy Detail

CRT indications, device selection (CRT-D vs CRT-P) and response evaluation.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Cardiac Resynchronisation Therapy Detail?

Cardiac resynchronisation therapy (CRT) is a device therapy that reduces heart failure symptoms and mortality through biventricular pacing that corrects left ventricular mechanical dyssynchrony.

Patients with LBBB morphology and QRS duration >=150 ms, EF <=35% and NYHA II-III have a class I indication. CRT-D adds defibrillator capability while CRT-P provides pacing only. Around 30% of patients are non-responders to CRT.

Symptoms

Symptomatic HFrEF despite optimal medical therapy
EF <=35%
QRS >=130 ms (preferably LBBB and >=150 ms)
NYHA II-ambulatory IV

Risk Factors

Non-LBBB morphology (lower response rate)
QRS 130-149 ms (borderline benefit)
Ischaemic aetiology (less responsive than non-ischaemic)
Right ventricular dysfunction
Atrial fibrillation (reduces biventricular pacing percentage)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Symptomatic HFrEF with wide QRS despite optimal therapy
  • Falling EF in an existing pacemaker patient (upgrade evaluation)
  • No symptomatic improvement after CRT (lead position check)

Treatment Methods

01
CRT-D implantation (EF <=35% with concomitant ICD indication)
02
CRT-P implantation (no ICD indication or limited life expectancy)
03
LV lead placement (coronary sinus posterolateral vein)
04
His-bundle or left-bundle area pacing (alternative CRT)
05
Echocardiographic optimisation (AV and VV delay settings)
06
6-12 month response evaluation (EF improvement, volume reduction)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.