If you have heart failure, your heart doesn’t work properly affecting the blood circulation and blood, oxygen and nutrient supply to different organs in the body. Cardiac Resynchronization Therapy- Defibrillator or CRT-D implant is a therapeutic procedure in which a medical device is inserted in patients with heart failure who re also at a risk of sudden cardiac death. CRT-D implant monitors the heart's rhythm, detects irregularities and corrects them with electrical impulses. Cardiac Resynchronization Therapy improves heart failure symptoms like fatigue, shortness of breath and exercise intolerance and significantly lowers the risk of life-threatening cardiac events. Many patients’ quality of life improves significantly with a CRT-D.
PREPARING FOR THE SURGERY
You will undergo cardiac check-up and other diagnostic tests for a detailed study of your heart failure and other medical condition to determine the risks associated. Before the Cardiac resynchronization therapy, you will be instructed to stop any blood-thinning medicines or supplements if you were taking. In addition, you should not eat for about 12 hours prior to the implantation.
ON THE DAY OF THE SURGERY
CRT-D implant procedure is done through small incision and is not an open heart surgery. Usually the surgery is done under local anaesthesia to numb the area in which you are awake but feel no pain during the procedure and in some cases general anaesthesia is also administered. After the surgical site is prepared, surgeon makes a small incision in the upper chest to locate a vein. After the vein is located it is punctured and a thin wire is inserted through it which reaches the heart, which is monitored through a monitor or X-ray machine. Surgeon then places the lead or wire in the best location from where it can provide energy to the heart. After placing the wire, doctor then makes incision in skin to make a pocket in which the device is placed. The surgeon will connect the leads to the defibrillator and program it to your specific medical needs.
After a test to ensure that the CRT-D is working correctly, the surgeon will close the incision with a few stitches. Surgery lasts for two to four hours.
After the surgery you will be kept in a recovery room for observation and once your vital signs are stable you will be shifted to a normal hospital room. You may feel discomfort and tiredness and your arm’s range of motion will probably be limited until the wound is completely healed. In some patients, the CRT-D forms a small, visible bulge underneath the skin which gets better with time. You may need hospitalization of one or two days.
Please follow post-operative instructions properly in order to recover faster. Avoid strenuous activity, especially lifting and other activities that use your upper body, which will help the incision where the CRT device was implanted time to heal and the lead(s) time to firmly attach to your heart tissue. Avoid rubbing your device or the surrounding chest area and walk, exercise, and bathe according to your doctor’s instructions. Full recovery from a CRT procedure can take a few days to a few months.
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Q: What are the advantages of a CRT-D implant?
A: Heart failure is a chronic, progressive disease. Early use of CRT therapy can help keep you alive longer and out of the hospital for heart failure.
Q: Does CRT-D implant cure heart failure?
A: No, CRT-D implant does not cure the heart failure, but it improves the quality of life and relieve the symptom such as shortness of breath.
Q: Is CRT-D implant surgery a painful procedure?
A: The sensation varies from person to person, when a CRT-D device shocks the heart in order to slow down a fast heartbeat, it uses higher energy. This gives a feeling that some people describe as a “kick in the chest.” Patients are under anaesthesia so procedure is not painful.
Q: Can I drive with CRT-D implant in my chest?
A: Generally, having a CRT device does not prohibit you from driving, although you may be asked to wait to drive during the early stage of recovery.
Q: Will a CRT-D implant be visible under my skin?
A: Your device will likely be noticeable under your skin. If you are worried about how this might look, talk to your doctor. In some cases, the device can be located somewhere that will be less noticeable.
Q: Using cell phone or other electronic device would affect my CRT-D implant?
A: Electronic device with electromagnetic waves might interfere the working of CRT-D implant. Cellular phones send electromagnetic signals, so they can interfere with your device’s function if you do not take precautions. To minimize risk of problems, keep your cellular phone away from the immediate area of your implant, and hold it to the ear farthest from the implant when making calls.
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