Cardiac Resynchronisation Therapy (CRT)
Cardiac Resynchronisation Therapy (CRT) is an advanced treatment option for selected patients with heart failure and poor left ventricular (LV) function. In these patients, the heart’s chambers often beat out of sync, particularly those with Left Bundle Branch Block (LBBB) and wide QRS complexes on ECG — who benefit the most from CRT.
By using a specialized pacemaker to synchronize the contractions of the heart’s ventricles, CRT helps achieve positive cardiac remodeling — reducing heart size, improving LV function, and decreasing secondary mitral regurgitation (MR). Over time, this therapy has been proven to reduce hospitalizations and mortality due to heart failure, significantly improving both longevity and quality of life.
Who Benefits from CRT?
CRT is specifically recommended for heart failure patients who:
- Have compromised Left Ventricular (LV) function (low ejection fraction).
- Remain symptomatic despite receiving optimal medical therapy.
- Show a specific electrical conduction delay on ECG — typically a Left Bundle Branch Block (LBBB) with a wide QRS complex (usually > 130 ms).
Maximizing Benefit
To achieve the best outcomes, CRT device programming and optimization are crucial. The timing of pacing must be precisely tailored to each patient’s cardiac physiology. The expertise of an experienced cardiologist is essential to ensure maximum long-term benefit and improved quality of life.