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What is cardiac resynchronization therapy (CRT)?

Also called biventricular pacing, CRT is a treatment for serious heart failure. CRT sends tiny electrical signals to both sides of your heart, causing the two lower chambers to beat at the same time, as they should. Along with your heart medicines, CRT can improve your heart's ability to supply blood and oxygen to your body and make you feel better.


What does the CRT procedure involve?

In a special room, the doctor will place the small device under the skin on your chest, probably on the left side under the collarbone. (Tell your health care provider if this would be a problem for any reason; for example, because you have a hobby such as hunting.) The device is connected to your heart with small wires (leads) inserted through your veins.


How do I prepare for the procedure?

If you take Coumadin (warfarin), your health care provider will tell you when to stop taking it before the procedure and may give you another blood-thinning drug to take instead. To prevent infection, you may receive antibiotics before and after the procedure. If you have chest hair, it will be clipped before surgery.


During the procedure, you'll receive medicine through an intravenous (I.V.) line to keep you comfortable.


What happens afterward?

The morning after the CRT device is implanted, the doctor will check your incision and change the dressing. You can usually remove this dressing the day after you go home. (The butterfly bandages over the incision should fall off by themselves in about 7 days.)


You can shower on the third day after surgery, but don't soak in the tub. Wash the incision area with mild soap and water and keep it dry. Don't use lotions, creams, or powders in this area.


Leave the incision uncovered so you can keep an eye on it. For the first week, it may look puffy and feel a little tender-and that's okay. But call your health care provider if it becomes red, more swollen, or hard; if it hurts more; or if you see fluid draining out. Take your temperature at about the same time each day. Call your health care provider immediately if you have a temperature of 100.4[degrees] F (38[degrees] C) for more than 2 days.


Your health care provider will prescribe medicine for pain and tell you how to take it. If you take Coumadin, restart it as directed by your health care provider.


Your arm on the side of the incision will be in a sling to keep it still for 24 hours. After that, you should start using your arm, but don't raise it over your head for 2 weeks. Don't lift heavy objects for a few weeks and don't play sports or drive until your health care provider says you can.


When you leave the hospital, you'll be given a pacemaker identification card. Always carry it with you.


Will electricity or magnets interfere with the CRT device?

Most equipment that uses electricity or magnets won't affect your CRT device. Check the product information for the equipment you're using to make sure you're keeping a safe distance. Check with your health care provider before any dental or medical procedures. For example, patients with CRT devices can't have magnetic resonance imaging (MRI).


Keep your cell phone at least 6 inches (15 cm) away from your CRT device and hold it on the side of the body opposite the CRT device when making a call. When you travel, tell airport security staff that you have an implanted device and show them your pacemaker identification card.