Crt

My mother is 85 with stage 3 heart failure. HFrEF She also has a left bundle branch block with some leaky heart valves.  I was looking into crt for her.  She has shortness of breath mainly and is starting to get more tired when she walks.  I was wondering if any one has a similiar condition and had CRT.  I was trying to see how successful the procedure is in improving symptoms, and how difficult going through the procedure is, and if there are complications.  Any comments appreciated.


3 Comments

CRT

by AgentX86 - 2022-05-11 02:31:35

Since no one has answered, let me take a stab at it. I'm substantially younger than your mother (almost 20 years when I got my PM) but I have had a (two lead) CRT-P pacemaker since day-1. Adding the third lead shouldn't be all that difficult. It's on the order of a first-time implant. A lead is added and the generator replaced. It's actually simpler because the pocket has already been made. The difficult part, as it always is withh a CRT, is getting the new lead into the coronary sinus. It's just a tricky procedure and can be made more difficult than by an unusual anatomy.  A practiced EP is strongly recommended.

Will it help? There are no guarantees in life but a more synchronized heart beat takes stress off the heart and in a significant number of cases will allow the heart to return to its normal size (if the problem is cardiomyopathy). IMO, if her doctors are recommending it, it's certainly worth a shot. It's not a huge risk (her doctors can quantify this more) and the reward can be significant. Life is all about risk/reward. Her doctors are responsible to lay this out for her. They NEED to explain both sides well enough for her to decide.

CRT (cardiac resynchronization therapy)

by Gemita - 2022-05-11 05:42:31

DBO,

I am glad you are watching over your mother.  There are many members here with CRT if you search under "Q" top right.  Some have found it extremely helpful in improving their heart failure symptoms and ejection fraction but this can take time (anything from 3+ months and continuing to up to a year) and will be different for each patient depending on their degree of heart failure and any other health conditions present.  For some unfortunately there may be little improvement but it is certainly worth a try because life is so precious.

CRT is not used in isolation to treat heart failure as you will know.  Medication, changes in diet/lifestyle and an exercise plan may all be used to effectively treat your mother and to help her to improve her quality of life.  It is the combination of treatments that can be so effective and make a real difference, so I would give CRT a try.  I am confident that your mother's doctors wouldn't have recommended CRT if they didn't believe it could help her.  Of course there are risks with any procedure, especially as we get older but hopefully your mother will do well, especially if she trusts her doctors and they have had a lot of experience implanting CRT systems in someone of her age?  Time to ask them some questions to help you to come to a decision.  To start you off, you could ask something like:-

.. how soon might I expect to see an improvement with CRT in terms of ejection fraction and relief from symptoms like breathlessness?

.. how long is the procedure likely to take providing there are no complications?  Would I have a general or local anaesthetic and how long would I spend in hospital?

.. what are the main risks of the procedure for an 85 year old patient with Stage 3 heart failure?

.. what other treatment options do we have available to try to improve my heart failure symptoms if we decide not to go ahead with CRT?

I hope for the very best outcome for both of you whatever decision you come to

CRT

by ROBO Pop - 2022-05-12 21:04:05

CRT's and other medical interventions can be a God send for many people, Unfortunately not everyone benefits due to their condition, the severity, and other factors. I'm one of those who didn't benefit although it's possible it's delaying progression of my condition. Even thoughI didn't see benefits, I'd do it again in a heart beat just to find out. I'm stage 4, with a sqeaking creaking valve, every arrhythmia known, coronary artery disease and in hospice so I'm not a good example. I would suggest you follow your moms wishes.

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