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Cardiac Resynchronization Therapy (CRT)

Device therapy that improves cardiac pumping by simultaneously pacing both ventricles in advanced heart failure.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Cardiac Resynchronization Therapy (CRT)?

Cardiac resynchronization therapy (CRT) is an implantable device therapy that simultaneously paces both ventricles in patients with advanced heart failure and ventricular dyssynchrony. It exists as CRT-P (pacemaker) and CRT-D (defibrillator).

It is indicated in patients with left bundle branch block, ejection fraction ≤35% and persistent NYHA II–IV symptoms despite optimal medical therapy. Benefit is greatest when the QRS duration is ≥150 ms.

CRT improves left ventricular contraction coordination, increases cardiac output, reduces mitral regurgitation and reverses left ventricular remodeling. Approximately 70% of patients achieve a clinical response.

Device implantation is minimally invasive; the left ventricular lead is placed via the coronary sinus. Regular device checks and programming optimization are critical for success.

Symptoms

Patients who meet CRT indications usually report:
Exertional dyspnea and exercise intolerance
Fatigue and weakness
Lower extremity edema
Orthopnea and paroxysmal nocturnal dyspnea
Reduced functional capacity

Risk Factors

CRT non-response (around 30% of patients)
Difficulty positioning the LV lead
Infection and lead dislodgement
Limited benefit in narrow QRS
Concomitant right ventricular failure

When to See a Doctor?

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

  • Persistent heart failure symptoms despite optimal therapy
  • Wide QRS on ECG (especially LBBB)
  • Lack of clinical improvement after CRT implantation

Treatment Methods

01
CRT-P or CRT-D device implantation
02
Echocardiographic optimization of AV and VV delays
03
Continued optimal medical therapy (ACEi/ARNi + beta-blocker + MRA + SGLT2i)
04
Regular device checks every 3–6 months
05
LV lead repositioning in non-responders
06
Exercise rehabilitation and lifestyle management

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.