device therapy

overview

Device therapy is also known as biventricular pacing or cardiac resynchronization therapy (CRT). With heart failure, the contraction of the lower chambers of the heart (ventricles) may not be coordinated. The heart may beat too slow, too fast or irregularly, which can result you not getting enough blood pumped through your body, causing symptoms such as shortness of breath, swelling or fatigue.

Device therapy for heart failure uses a special type of pacemaker to coordinate the contraction of the ventricles. The pacemaker sends electrical signals through special wires called leads to both ventricles, helping them beat in a coordinated fashion and improving blood flow. 

The pacemaker has a generator with a programmable computer chip and is battery-powered. CRT devices may have a defibrillator (CRT D) that can deliver shocks for life-threatening heart rhythm emergencies.

what to expect 

You’ll have your CRT placement done at the hospital and may need to stay the night. Your doctor will tell you about any foods or medicines you should avoid before the procedure. He or she may also have you prepare by washing your chest with a special soap and taking an antibiotic to reduce the risk of infection.

During the surgery, you’ll be given local anesthetic and intravenous medication to help you relax. It’s possible you may require general anesthesia; if so, an anesthesiologist will be involved with the procedure.

In most CRT procedures, an incision is made under your collarbone, and a pocket is formed under the skin, where the generator is placed. The doctor will thread placing leads through a vein and to your heart, guided by an X-ray. After it’s placed, the device system will be tested, but you won’t feel it. Finally, the incision will be closed and bandaged. 

recovery

Usually, you’ll be discharged from the hospital the day after your procedure. The dressing will be removed. Steri-strips covering the incision will remain in place until your follow-up appointment a week or two after you go home.

For 2 to 4 weeks, you should avoid lifting or doing any repetitive motions on the side of the implant. You can take a shower 48 hours after the procedure, but don’t let water beat directly on the incision, and keep showers short. Pat the area dry with a clean towel, and don’t use lotion or perfume in the area. You also shouldn’t take a tub bath, swim or drive a car until your electrophysiologist gives you the okay. Your doctor will also tell you when you may return to work or if you have any work restrictions.

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