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Cardiac resynchronisation therapy (CRT or CRT-P) is the insertion of electrodes in the left and right ventricles of the heart, as well as on occasion the right atrium, to treat heart failure by coordinating the function of the left and right ventricles via a pacemaker, a small device inserted into the anterior chest wall.
CRT devices have been shown to reduce mortality and improve quality of life in patients with heart failure symptoms; a LV ejection fraction less than or equal to 35% and QRS duration on EKG of 120 ms or greater. [18] [19] Biventricular pacing alone is referred to as CRT-P (for pacing).
The FDA approved the OPTIMIZER Smart System, which delivers cardiac contractility modulation therapy, as indicated to improve 6-minute hall walk distance, quality of life, and functional status of NYHA Class III heart failure patients who remain symptomatic despite guideline directed medical therapy, who are in normal sinus rhythm, are not indicated for cardiac resynchronization therapy, and ...
Using a special pacing algorithm, biventricular cardiac resynchronization therapy (CRT) can initiate a normal sequence of ventricular depolarization. In people with LVEF below 35% and prolonged QRS duration on ECG (LBBB or QRS of 150 ms or more), an improvement in symptoms and mortality occurs when CRT is added to standard medical therapy. [123]
Illustration of Implantable Cardioverter Defibrillator (ICD) An implantable cardioverter-defibrillator (ICD) or automated implantable cardioverter defibrillator (AICD) is a device implantable inside the body, able to perform defibrillation, and depending on the type, cardioversion and pacing of the heart.
Crosstalk can only occur in a dual chamber or biventricular pacemaker. It happens less often in more recent models of dual chamber pacemakers due to the addition of a ventricular blanking period, which coincides with the atrial stimulus. This helps to prevent ventricular channel oversensing of atrial output.
Pacemaker: Coordinates contractions between ventricles. In people at risk of arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD). ICDs: Small devices implanted in the chest to monitor heart rhythm and deliver electrical shocks to control abnormal heartbeats. The devices can also work as pacemakers.
Vascular dementia was found to have either comparable or worse survival rates when compared to Alzheimer's disease; [22] another 2014 study found that the prognosis for people with vascular dementia was worse for male and older people. [23] Vascular dementia may be a direct cause of death due to the possibility of a fatal interruption in the ...