Cardiac resynchronization therapy device

Case contributed by Dr Callum Smith

Presentation

Mixed ischemic and non-ischemic cardiomyopathy

Patient Data

Age: 80 years
Gender: Female

Cardiac resynchronization therapy (CRT) device in situ (right atrial, right ventricular and coronary sinus leads). An insulated right ventricular lead indicates that this is a CRT defibrillator device. The cardiac silhouette is enlarged. There is no confluent consolidation.  

Case Discussion

Cardiac resynchronisation therapy (CRT) is indicated in patients with heart failure (moderate to severe), systolic dysfunction (left ventricular ejection fraction <35%) and prolonged QRS duration despite being treated with appropriate pharmacotherapy. CRT works through simultaneous pacing of the right and left ventricles. The goal of CRT is to improve the patient's left ventricular dyssynchrony which is largely secondary to a left bundle branch block. CRT devices may also have defibrillator capacity 1-2.

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