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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).
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.
Just like pacemakers, ICDs can have a single wire or lead in the heart (in the right ventricle, single chamber ICD), two leads (in the right atrium and right ventricle, dual chamber ICD) or three leads (biventricular ICD, one in the right atrium, one in the right ventricle and one on the outer wall of the left ventricle).
The biological pacemaker is intended as an alternative to the artificial cardiac pacemaker that has been in human use since the late 1950s. Despite their success, several limitations and problems with artificial pacemakers have emerged during the past decades such as electrode fracture or damage to insulation , infection , re-operations for ...
Biventricular pacemaker; Biventricular pacing without internal cardiac defibrillator; Implantation of cardiac resynchronization (biventricular) pulse generator pacing device, formation of pocket, transvenous leads including placement of lead into left ventricular coronary venous system, and intraoperative procedures for evaluation of lead signals.
Since pacemaker correction of the third-degree block requires full-time pacing of the ventricles, a potential side effect is pacemaker syndrome, and may necessitate the use of a biventricular pacemaker, which has an additional 3rd lead placed in a vein in the left ventricle, providing more coordinated pacing of both ventricles. [citation needed]
In Cardiac Resynchronization Therapy (CRT) procedures, a critical step involves the insertion of a pacing lead into the coronary vein system. However, the anatomical configuration of the coronary sinus (CS) exhibits significant variability, necessitating that cardiologists assess and evaluate its characteristics during the procedure.