Cardiac Resynchronization Therapy (CRT)

Overview

Patients with severe heart failure and conduction malfunction (dyssynchrony) can experience improvement with a biventricular pacemaker (CRT) treatment. Several studies (InSync, MIRACEL, MUSTIC, COMPANION, CARE-HF) have shown that 70% of all patients who receive CRT will experience an improvement of symptoms, increased EF%, and less need for hospital care. A study and a meta-analysis showed a 35% improvement in mortality, and national and international studies have shown that CRT treatment has a sound scientific base.

The process involves the use of a regular pacemaker with an additional electrode in the sinus coronarius in order to pace the left ventricle. The aim is to synchronize the activation of both ventricles optimally.

Implantations of biventricular pacemakers have been carried out at Örebro University Hospital since 2002; in 2006, 20 such systems were implanted.

At present, we use CRT devices from two companies; Medtronic (Insync III) and St Jude (Frontier). Pacemaker durability is very variable, but they usually last 4-5 years before replacement is necessary.

A system costs about €3950–4900 with electrodes. Some of these devices also include an ICD function, and are then much more expensive. This type of treatment is significantly underutilized, but hopefully its use will increase in the future.


Page revised Wednesday, May 11, 2011

Content manager: Thomas Kronvall

Published by Anita Pettersson

Contact

Switchboard: +46 19 602 10 00

Thomas Kronvall

Peter Linde