Cardiac Resynchronization Therapy (CRT) & Conduction System Pacing 

Cardiac resynchronization therapy (CRT) and conduction system pacing are two techniques used to treat patients with advanced heart failure, a condition in which the heart isn’t pumping as forcefully as it should. CRT and conduction system pacing implant electronic devices that help the heart have a more balanced heart rhythm to improve cardiac function and reduce symptoms, like shortness of breath. 

Conditions Treated 

CRT and conduction system pacing isn’t the appropriate treatment for everyone with heart failure. Those with an ejection fraction (a measurement of how much blood is being pumped out of the heart’s left ventricle) under 35% may be eligible along with patients who: 

• Are experiencing severe heart failure symptoms, such as shortness of breath, swelling, dizziness or fainting 
• Have a history of cardiac arrest or are at increased risk 
• Take medications for heart failure 
• Have delayed electrical activation of the heart 

Treatment Details 

Tampa General Hospital’s Heart & Vascular Institute features some of the most skilled electrophysiologists in the nation who provide world-class care for even the most complex heart failure cases. At our state-of-the-art facility, we provide: 

Cardiac Resynchronization Therapy (CRT) 

CRT uses biventricular pacemakers (BVP), which send electrical signals to the lower chambers of the heart (ventricles) to trigger them to contract, therefore improving the heart’s pumping mechanism. The BVP device has multiple leads (wires that send electrical signals) that are positioned in both ventricles and the right atrium (upper chamber of the heart). If the patient’s heart rate drops below a certain rate (as programmed by the electrophysiologist), the BVP will fire off an electrical signal to instruct the ventricles to contract.

Conduction System Pacing 

TGH is one of only five centers in the United States to offer conduction system pacing as an alternative to CRT. It’s an innovative technology that uses an electronic device to directly stimulate the conduction system of the heart. More specifically, it stimulates the bundle of His, which is a group of fibers that carries electrical impulses to the ventricles of the heart. In some instances, the device can become even further focused with its stimulation by directly triggering the left section of the bundle of His. This method entails implanting leads within the ventricular septum via the right ventricle. Studies have shown that conduction system pacing can deliver more effective ventricular resynchronization than CRT, leading to improved outcomes for heart failure patients. 

What to Expect

After the implantation procedure, expect to stay in the hospital overnight so that you can be closely monitored. Typically, you’ll be placed on a telemetry monitor and/or a Holter monitor, both of which measures heart rhythm. Before you are discharged from the hospital, you may need to receive an echocardiogram to evaluate your heart function. Your electrophysiologist will also program your device to its appropriate settings. 

Effectiveness  

CRT and conduction system pacing are currently the only known therapies for heart failure that improve cardiac function, exercise ability and mortality while decreasing hospitalizations.  

TGH’s Electrophysiology Center of Excellence is a leader in CRT and conduction system pacing. Led by world-renowned electrophysiologists who have participated in several revolutionary clinical trials on the impact of resynchronization and conduction system pacing, the center is committed to delivering a multidisciplinary approach for patients with advanced heart failure.