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Preparation
Ventricular dysynchrony is a condition in which the ventricles (two bottom chambers of the heart) do
not beat at the same time. This condition is typically accompanied by congestive heart failure.
If you are diagnosed with this condition, Dr. Moore may recommend cardiac synchronization therapy
(CRT). The CRT procedure is very similar to a pacemaker or implantable cardioverter defibrillator
(ICD) implant, except that you'll receive either CRT-P (cardiac resynchronization therapy pacemaker)
or a CRT-D (an ICD that can pace a brachycardia rhythm). During this procedure, electronic pacing
leads will be placed in your right ventricle, as well in a coronary vein that essentially allows
pacing of the left ventricle simultaneously. In certain patients with congestive heart failure (CHF),
this technique will improve the efficiency of heart pumping in order to improve blood flow around
the system.
A battery that will last many years before it needs to be replaced will power your CRT device. Once
your device is inserted, you'll have it checked at least twice per year to ensure that it's
functioning properly.
Dr. Moore performs CRT's at Indian River Memorial Hospital. To prepare for this procedure, you must:
- Inform Dr. Moore if you may be pregnant
- Abstain from eating or drinking at least six to eight hours prior to the test
You may have to stop taking certain medications, such as aspirin, Plavix or warfarin therapy, prior to
this procedure and obtain pre-procedure blood work. You also may have to pre-register for this
inpatient procedure. Dr. Moore and his staff will provide you with specific instructions.
Procedure
Once you have registered, changed into a hospital gown, and been situated in bed, you'll receive an
intravenous (IV) line that will be used to administer a mild sedative that will help you relax during
the procedure. You'll still be awake and somewhat responsive during the procedure, but many patients
find they don't remember much afterwards. Electrodes will be attached to your chest to monitor your
heart, and a cuff will be placed on your arm to monitor your blood pressure.
Once you have been sedated, the cardiologist will make an incision on the left side of your chest.
This incision will create a small pouch for the CRT device. Next, the cardiologist will use
fluoroscopy, a special x-ray technique that captures and stores images in real-time, to guide the
device leads and properly place them in your heart. The leads are then attached to the CRT generator
and the CRT is inserted into the pouch. The small incision is closed with stitches. The implantation
generally takes about an hour.
Post-procedure
You'll usually be required to spend the night in the hospital, so the cardiac team can monitor your
heart and ensure that the device is working properly. After the procedure, a follow-up appointment
with Dr. Moore will be scheduled. Resume your normal medication schedule as instructed by Dr. Moore.
You may notice a gradual increase in your energy level within weeks of having the device implanted.
Like a pacemaker or ICD implant patient, you should carry an official device card in your wallet that
indicates that you have a CRT device. Some security systems, such as at the airport, may detect your
device. You should also inform all of your physicians and dentist of your device. Lastly, most
electronic equipment does not interfere with CRT devices, but some especially strong electrical
and magnetic devices can disrupt the way the device works. Be aware of your surroundings, and if you
have questions, ask your cardiologist.
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