PROCEDURES
CARDIAC RESYNCHRONISATION THERAPY
Cardiac resynchronisation therapy is done for those who have heart failure and have developed arrhythmia. A Cardiac Resynchronisation Therapy (CRT) device can ‘retune’ the heart’s timing to reduce or eliminate symptoms while also helping to prevent further weakening of the heart.
WHY DO I NEED IT?
In a large percentage of patients with heart failure, dyssynchrony occurs, which means that their hearts do not just beat poorly, but ineffectively as well. This means that energy is wasted since the two walls of the heart works against each other rather than working with each other worsening the symptoms of heart failure that patients experience as well as shortening their lives. Cardiac resynchronisation therapy is a revolutionary way of treating patients with heart failure helping improve the effectiveness with which their heart beats. A special type of pacemaker can be inserted with 3 wires instead of the usual 2. The 3rd wire gets inserted into the left heart via a large vein running across the heart to the furthest wall of the heart. This is inserted during a procedure similar to a regular pacemaker insertion. This restores the synchrony of your heart, improving the amount of work your heart can do.
HOW IS IT DONE?
Cardiac resynchronisation therapy involves Dr van Rensburg implanting this special type of pacemaker, usually just below the collarbone. The procedure is usually performed under a local anaesthetic and you may be given sedation, which will make you relaxed. Your doctor will inject some local anaesthetic under the skin just below your collarbone (usually the left side). This will numb the area and allow your doctor to pass the leads through the vein that comes from your arm and runs into your heart. The leads of the device are then connected to the pulse generator. This generator is larger than conventional pacemakers given the additional wire and benefits that it provides. This will be placed under the skin in your chest. Your doctor may test the device during the procedure to ensure it is working correctly. You may feel your heartbeat go faster as your doctor tests each lead in turn. The incision will then be closed with stitches.
The leads connected to the device monitor the heart rate to detect heart rate irregularities and emit tiny pulses of electricity to correct them. In this way, the device is “resynchronising” the heart.
WHAT ABOUT AFTERWARDS?
You’ll usually stay overnight in the hospital after cardiac resynchronisation therapy. Dr van Rensburg will test your device to make sure it’s programmed correctly before you leave the hospital. Most people can return to their usual activities after a few days.
Because cardiac resynchronisation therapy improves the heart’s efficiency and increases blood flow, patients have reported alleviations of some heart failure symptoms - such as shortness of breath. Clinical studies also suggest decreases in hospitalisation and morbidity as well as improvements in quality of life.