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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.
Percussive pacing, also known as transthoracic mechanical pacing, is the use of the closed fist, usually on the left lower edge of the sternum over the right ventricle in the vena cava, striking from a distance of 20 – 30 cm to induce a ventricular beat (the British Journal of Anaesthesia suggests this must be done to raise the ventricular pressure to 10–15 mmHg to induce electrical activity).
All three presentations allow distinct and easily reproducible electrical signatures as illustrated by left and right bundle branch blocks, hemiblocks, etc. The concise measurement of the time and morphology of the QRS interval allows the interventional ability to manipulate this interval with biventricular pacemakers.
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. [122]
In the latter 1990’s Kass began research into applying pacing stimuli to both sides of a failing heart. This approach was later called cardiac resynchronization therapy (CRT) . His work showed that with CRT net systolic function was enhanced without commensurate increases in oxygen consumption, [ 17 ] that is, the heart became more ...
This research has documented substantial improvements in cardiac output among heart surgery patients undergoing biventricular pacing (also known as cardiac resynchronization therapy), which involves installation of pacemakers to fix delays in heart ventricle contractions and keeps the left/right ventricles pumping together (CUMC 2007).
1 Promoting Healthy Choices: Information vs. Convenience Jessica Wisdom, Julie S. Downs and George Loewenstein Contact Information: We thank the USDA Economic Research Service and the Center for Behavioral Decision
CRT: People with NYHA class III or IV, left ventricular ejection fraction (LVEF) of 35% or less and a QRS interval of 120 ms or more may benefit from cardiac resynchronization therapy (CRT; pacing both the left and right ventricles), through implantation of a bi-ventricular pacemaker. This treatment modality may alleviate symptoms, improving ...
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