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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).
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.
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.
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 ...
Pacemaker syndrome is a condition that represents the clinical consequences of suboptimal atrioventricular (AV) synchrony or AV dyssynchrony, regardless of the pacing mode, after pacemaker implantation. [1] [2] It is an iatrogenic disease—an adverse effect resulting from medical treatment—that is often underdiagnosed.
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.