Could a CRT pacemaker help my heart failure?

Pacemaker on an x-ray

I have heart failure and was told a CRT pacemaker might help. What is a CRT pacemaker and how could it help?

Darrel Francis, Professor of Cardiology at Imperial College London, says:

Heart failure means you have a weakly pumping heart that can’t keep up with everyday activity. You may get breathless or tired during moderate or even minor exertion, so everyday life can become progressively more restrictive and uncomfortable. Severe cases of heart failure can lead to emergency hospitalisations and even death.

When the heart becomes enlarged in heart failure, its electrical circuits can become stretched, leading to communication breakdown between different parts of the heart. This scrambles the normally beautifully coordinated way that your heart contracts to pump blood, making it disorganised and inefficient. In the worst case, one wall of the heart can be contracting while the other is relaxing, so instead of blood being pumped out, it simply slops around inside the heart.

The CRT pacemaker is the current top of the technological tree. With BHF support we hope to take this even further

A special advanced pacemaker called a cardiac resynchronisation therapy (CRT) pacemaker (also called a biventricular pacemaker) can be implanted to help with this problem. It works in the same way as a normal pacemaker in controlling the heartbeat, but it also sends small electrical venesection every three or impulses to the left and right ventricles to help them contract at the same time. These devices have had stunning success in improving health and survival.

The BHF has solidly supported CRT research, including the pioneering work of Dr Zachary Whinnett here at Imperial College London. Dr Whinnett has developed advanced computer algorithms to improve pacemaker function, and has introduced new methods that may do even more to reduce symptoms and enhance quality of life for people with heart failure. Thanks to BHF support, he is leading the HOPE-HF trial of these new techniques. The CRT pacemaker is the current top of the technological tree. With BHF support we hope to take this even further.

CRT pacemakers do not help in all cases of heart failure, but we now have highly effective medications, such as ACE inhibitors and beta blockers. The other thing that really helps in cases of heart failure is keeping active. BHF researchers have shown the value of regular physical exercise in heart failure. This not only reduces everyday symptoms, but seems to prevent emergency deterioration and even deaths.

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