Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Houston Methodist DeBakey Heart & Vascular Center

Cardiac Resynchronization Therapy (CRT)

In some people with heart failure, the left and right sides of the heart can become "out of synch" with each other, which can worsen symptoms such as shortness of breath and swelling. Cardiac resynchronization therapy (CRT), sometimes called biventricular pacing, can alleviate this condition by using an implanted pacemaker to send signals to both sides of the heart, making sure that they pump in the correct timing.

View the Emmi video education program on CRT (you will need to enter some basic information to access the program)

Preparing for CRT Implantation Surgery

Before your surgery, your doctor will ask you a series of questions to evaluate your overall health and your history. Make sure to answer all his or her questions thoroughly. Tell your doctor if you are left-handed, as this will determine on which side of your chest to place the device.

Tell your doctor about any medications you are taking, including aspirin, vitamin supplements, or over-the counter drugs.

You will also want to have a friend or family member accompany you. This person can provide comfort and support as well as being a "go to" for your medical team.

Make sure you understand how long you will be in the hospital (it could be 1–2 days, or you could go home the same day), how long you will need to be off work, and how long before you can return to regular activities.

Do not eat or drink anything after midnight the night before your surgery. If your doctor tells you to take any of your medications on the day of your surgery, take them with just a sip of water.

What Happens in Surgery

Treatment for Heart Failure - Cardiac Resynchronization Therapy (CRT)©2012 Emmi Solutions, LLC

You may be given a medication to help you relax, but you probably will not be completely asleep during surgery, since your doctor may need to communicate with you during the procedure. (You may, for example, be asked to cough or take a deep breath from time to time.)

  1. An area on your chest will be numbed with a local anesthesia.
  2. Your doctor will make a 2–3 inch cut just below your collarbone to create a "pocket" for the CRT.
  3. The surgeon will use an X-ray machine to guide the first lead into the heart.
  4. Once the tip of the lead is in place, it will attach to the heart with a small screw or tine.
  5. Your surgeon will repeat steps 4 and 5 for the second and third leads.
  6. After the leads are attached, your surgeon will test them to make sure they work properly. You may also be asked to cough or take some deep breaths to make sure the leads are secure.
  7. The surgeon will attach the leads to the CRT and place it into the "pocket" in your chest. He or she may do some simple tests to make sure it is working properly.
  8. Your surgeon will close the incision in your chest with stitches, staples or surgical glue.

After Your Surgery

Right after surgery you may feel a little groggy. You will also have electrodes attached to your chest; these are part of a telemetry monitor that keeps track of your heartbeat.

Before you go home, you will have a chest X-ray to ensure that everything looks good, and your doctor may prescribe new medications or change the ones you currently take. Make sure to follow all instructions you receive upon leaving the hospital.

You will also be given a temporary ID card that identifies you as having a CRT. It is important to have this card with you at all times in case of any emergency, and you will also need it for situations like going through airport security. Your medical team will explain more when they give you your temporary card, and you can expect to receive a permanent card from the device manufacturer in the mail after a few weeks.

Your doctor will give you very specific instructions on what you should and should not do for 4-6 weeks after surgery. Make sure to follow his or her instructions carefully.

For more information, visit the After You Are Discharged section of this site.

Make sure to contact your doctor immediately if you experience any of the following symptoms:

  • Fever of 101° or higher
  • Chills
  • Sudden shortness of breath
  • Chest pain
  • Pain or swelling in one of your arms, especially the arm on the same side as the CRT
  • Pain, redness or swelling in the area where surgery was done
  • Fluid or pus drains from your wound
  • If the area bleeds, or if the wound itself opens up

Learn more about treatments for heart failure:

For more information about heart failure treatment at the Houston Methodist DeBakey Heart & Vascular Center or to make an appointment, please call us at 713-DEBAKEY (713-332-2539) or complete our online contact us form.