You might need a CRT-P if:
- You have symptoms of heart failure despite medication and lifestyle changes
- Your heart beats too slow
- The left side of your heart is beating out of time with the right side
How it Works
A traditional pacemaker has one or two leads that are placed into the right side of your heart. One lead is placed into the lower right chamber, called the right ventricle. A second lead may be placed into the right upper chamber, called the right atrium. A CRT pacemaker (CRT-P) has an additional lead placed on the left side of the heart to make the left ventricle beat at the same time as the right. This can restore your heart’s coordination so it pumps efficiently.
Implanting the CRT-P
Usually, your doctor will give you 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 during the procedure. Numbing medication will be given where the incision is made. You may, however, feel some pressure while the device is being implanted.
The procedure to place a pacemaker 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 lead placement using a large overhead monitor called a fluoroscope.
- Once the leads are in place, your doctor tests them to make sure they are in the best position to deliver energy to the heart.
- Your doctor might ask you to go through some simple maneuvers, such as taking a deep breath or coughing vigorously, to make sure the lead is stable.
- Your doctor makes a “pocket” by separating the skin and underlying tissue from the muscle beneath the tissue.
- The pulse generator is connected to the leads and placed 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
Many patients get relief from symptoms such as lightheadedness, dizziness and fainting. Some people feel they have more energy.
- A CRT-P also gives many patients “peace of mind.” They feel safer because the CRT-P can keep their hearts beating.
- A CRT-P may also help alleviate your heart failure symptoms, such as fatigue or shortness of breath.
You may experience other benefits from a CRT-P. Your doctor is the best person to help you understand them.
A small number of patients develop complications from the operation to implant the CRT-P and the leads in the body. These can include infection, a reaction to a drug used during surgery, blood loss, or damage to a blood vessel, the heart wall, or other organ. These complications can usually be corrected or cured.
The CRT-P may not always eliminate all symptoms of the heart failure. You may still feel lightheaded or dizzy, or you may faint.
After the surgery, you may feel some discomfort or feel tired, but these feelings only last a short time. Some patients, however, may continue to feel a bit uncomfortable in the area where the CRT-P was implanted.
Modern CRT-Ps have many safety features. Sometimes, a CRT-P may not act properly because it is being affected by outside sources of electromagnetic energy.
It is also possible for the tip of the lead to shift in the heart so that the pulse is no longer effective. Very rarely, the device may slip out of the “pocket” in the chest.
Finally, remember these are man-made devices. It is important to monitor the device regularly with follow-up visits as often as your doctor recommends.
Talk to your doctor to better understand your potential benefits and risks. See Important Safety Information for additional information.
CRT-P Devices from St. Jude Medical
St. Jude Medical’s CRT-P portfolio, including advanced CRT-P devices and leads, provides the technology needed to effectively treat heart failure.
Living With Your CRT Device [PDF]
- Treatment Options: CRT Pacemakers (CRT-P)
View Understanding Heart Failure and Treatment Options Animations
Last Reviewed: April 25, 2011 V-00304