Cardiac Resynchronization Therapy: Basic Knowledge

In case your physician has recommended implantable cardiac resynchronization therapy to you, you will receive detailed instructions about how to prepare for the surgery. Your cardiologist may advise the following among other things: 

• To stop taking blood-thinning medication several days before surgery. 

• To stop eating for about 12 hours prior to the implantation. 

• If you take other medication regularly, ask your physician if you should continue taking the medication before your procedure. 

In addition to the information your healthcare professional will provide, we have put together frequently asked questions and a checklist that you might want to look at and go over with your physician. 

Implanting a CRT-P or CRT-D is a relatively simple surgery that lasts between two and four hours. It is not performed on an open heart. It is carried out under local anesthesia, and sometimes, short-term sedation. You will also be given antibiotics to reduce the risk of inflammation or of an infection. 

After preparing the incision site, the physician will make a cut in your upper chest, well below your shoulder. The surgeon will insert three special wires, called leads, into a major vein near your collarbone. Using X-ray for visibility, the surgeon will guide the leads through your veins and place them in the heart’s upper and lower chambers. Then, the physician will implant the CRT-P or CRT-D in a pocket created at the incision beneath the skin. The surgeon will connect the leads to the device and program it to your specific medical needs. After a test to ensure that the implant is working correctly, the surgeon will close the incision with a few stitches. 

Usually, you will stay in the hospital for one or two days after the implantation. Listen carefully to and follow your physician’s instructions. At home, monitor how the incision is healing. In some patients, and this is perfectly normal, the device forms a small but visible bulge underneath the skin. Your arm’s range of motion will probably be limited until the wound is completely healed.

From now on, you will have regular follow-up appointments where your physician checks the information your device has stored. He or she will also make necessary therapy adjustments in case they are needed. Please always carry your patient identity card with you so that it is available in case of an emergency.

Of course, you will need some time to get used to living with a device and may have many questions regarding working, traveling or practicing sports. Please also familiarize yourself with how electromagnetic interference can influence your devices’s functionality and what to bear in mind when undergoing medical examinations such as an MRI.