Cardiac Resynchronisation Therapy (CRT)

Every medical procedure has some risks. For CRT the exact risks depend on the type of device used and your general health. Possible complications from this therapy and the procedure to insert the device include:

• Infection.
• Bleeding or bruising.
• A collapsed lung.
• Fluid buildup around the heart (which can compress it).
• The device not working properly.
• Parts of the device moving, which might need another procedure to fix.

Eating and drinking 

• If your procedure is in the morning, you should not eat or drink anything after 02:00. You can have small sips of water until the procedure.
• If your procedure is in the afternoon, you should not eat or drink anything after 07:00, but you can still have water after that time.

Once your procedure is over you can eat and drink normally. 

Medication

Before your procedure, you will have a pre-op assessment with a cardiology nurse. They will talk to you about your medications at that appointment. Please keep taking all your medications until then. If you need to stop any of them before your procedure, they will tell you.

The device is placed in your chest, usually under your left collarbone. This happens in a special area of the hospital called the Cardiac Cath Lab. 

• You will lie on your back on the table for the procedure, and be connected to monitors and covered with sterile sheets.
• You can have medication to help you relax but you will stay awake. You will also be given antibiotics to prevent infection.
• The area where the device will be inserted will be cleaned and numbed, so it wont hurt.
• A small cut will be made on the left side of your chest, and a thin tube inserted into a large vein. Using this tube and an X-ray camera, the doctor will carefully guide leads into your heart.
• These leads will be tested and connected to the device.
• A small pocket will be created under your skin to hold the device, and the device will be carefully placed inside.
• The cut will be closed with stitches that dissolve on their own and a special glue, then a bandage will be put over.
• The procedure usually takes a few hours.

After the procedure, you will spend a little time in the recovery area. You will either stay overnight in a ward, or go back to the ward you were in before.

Looking after the wound

Your wound might feel sore and look bruised for a couple of weeks which is normal. If you have pain, you can take painkillers. Keep the wound clean and dry for about 7-10 days, after this you can take off the dressing. The scar should heal in about six weeks.

Using your arm

It is important to be gentle with the arm on the same side as the CRT device. Use it normally, but avoid raising it above your shoulder or lifting heavy objects. This is because over time new tissue will grow around the lead in your heart, helping to hold it in place. Until that tissue forms there is a slight chance that the lead could move out of position (this would mean we need to reopen the wound to fix it).

If you have any questions about how to use your arm, please ask for help.

Once your wound is fully healed, you can mostly return to your normal routine. Your CRT device will need to be checked regularly to make sure it is working properly.

After the device is put in, you will have a check-up 24 hours later, and then another one six weeks after that, where the wound will also be looked at. After that, you will need check-ups every six months. Each check-up takes about 15 to 20 minutes. It's important to remember that these appointments are just for checking the CRT and are separate from any other visits you have with your cardiologist.

When you come in for a check-up, they will keep an eye on your heart rate. An external device will be placed on your chest to read the CRT. If you have had any symptoms since your last visit, make sure to tell the technician. You might notice your heartbeat feeling a little different during the check—maybe a bit faster or slower. If you ever feel uncomfortable, tell the technician right away. They can adjust the CRT to help it work better for you.

At the end of the check, you will learn if there are any issues, and you will be told when your next appointment will be (in either three or six months). You will also get an appointment letter once it is booked.