CRT Implantable Cardioverter Defibrillators (ICD)
with Pacing Capabilities (CRT-D)

Green Box Background

A CRT-D can deliver an electric shock within seconds if your heart rhythm becomes dangerously fast.

 

You may need a CRT-D if:

  • You have heart failure
  • You have previously had or are at risk for having ventricular tachycardia (VT) or ventricular fibrillation (VF) causing your heart to beat too fast
  • You have damage to the pumping action of your heart caused by a heart attack 

How it Works

A standard ICD is implanted like a normal pacemaker, with either one or two leads in the right side of heart. Unlike a traditional pacemaker, a CRT-D has an extra lead on the left ventricle to make the heart pump in a coordinated way.

CRT-D Device

Implanting the CRT-D

Usually, the procedure for an implanted cardiac device involves medication to help you relax, but you will still be aware of your surroundings and will be able to hear and even talk with the medical team as the procedure is being conducted. Numbing medication will be given where the incision is to be made. You may, however, feel some pressure while the device is being implanted.

The procedure to place an ICD like a CRT-D typically follows these steps:

  • Your doctor makes a small cut in the upper chest and locates a vein.
  • A small puncture is made in the vein and the leads are guided down the vein to the heart.
  • The surgical team monitors the progress of the leads using a large overhead monitor called a fluoroscope.
  • Once they are in place, your doctor tests the leads to make sure they are in the best position to deliver energy to the heart.
  • Your doctor plugs the leads into the CRT-D.
  • Your doctor makes a pocket by separating the skin and underlying tissue from the muscle beneath the tissue and places the CRT-D in the pocket.
  • The incision is closed.

The length of the surgery depends on what kind of device you are getting, as well as your specific anatomy and the time it takes to locate a good position for the lead. 

Benefits and Risks

Benefits

The major benefit of a CRT-D is that it constantly senses the heart’s rhythm and automatically treats an arrhythmia that may be associated with your heart failure diagnosis. If your arrhythmia is very dangerous, this treatment can save your life. Also, many patients find that symptoms such as lightheadedness, dizziness and fainting decrease after they get a CRT-D. Some patients no longer need anti-arrhythmia drugs, and others need less anti-arrhythmia medication.

A CRT-D gives many patients more “peace of mind.” They feel safer because the CRT-D will automatically treat their arrhythmia. A CRT-D may also help alleviate your heart failure symptoms, such as fatigue or shortness of breath. You may experience other benefits from a CRT-D. Your doctor is the best person to help you understand them.

Risks

Your doctor is the best source of information about the risks of getting a CRT-D. Be sure to talk about all your questions and concerns. Some possible risks of CRT-D treatment are discussed below.

A small percentage of CRT-D patients will develop a complication because of the implant surgery. They may include infection, a reaction to a drug used during surgery, blood loss, or damage to a blood vessel, the heart wall, or other organ. After the surgery, you will feel some discomfort, and you will be tired. As you recover, you will feel better. However, some patients continue to feel some discomfort where the CRT-D is implanted.

It is important to follow certain precautions after you get a CRT-D. Your doctor will discuss them with you.

When an arrhythmia occurs, CRT-D treatment may not end it, or treatment may make the arrhythmia worse. In either case, the CRT-D then delivers stronger treatment to try to end the arrhythmia. The CRT-D may not always eliminate all symptoms of the arrhythmia. You still may feel lightheaded or dizzy, or you may faint.

Talk to your doctor to better understand your potential benefits and risks. See Important Safety Information for additional information. 

CRT-D Devices from St. Jude Medical

St. Jude Medical’s CRT-D portfolio provides the technology needed to effectively treat heart failure. 

Downloads

Living With Your CRT Device [PDF]

Animations

Recommended animation:

  • Treatment Options: CRT Implantable Cardioverter Defibrillators (Heart Failure ICD or CRT-D)
  • Types of Heart Failure: Right-Sided Heart Failure

View Understanding Heart Failure and Treatment Options Animations

Last Reviewed: April 25, 2011 V-00304