CRT-D
Also written as: CRT-D — Cardiac Resynchronization Therapy with Defibrillator
Cardiac resynchronization therapy with defibrillator capability, combining pacing therapy for heart failure with arrhythmia protection.
Full Definition
Cardiac resynchronization therapy with defibrillator (CRT-D) is an advanced cardiac device that combines the functions of a cardiac resynchronization therapy pacemaker with an implantable cardioverter-defibrillator. The device uses biventricular pacing to improve cardiac synchrony in patients with heart failure and wide QRS complexes, while also providing protection against sudden cardiac death through defibrillation and anti-tachycardia pacing capabilities. CRT-D is indicated for patients with symptomatic heart failure despite optimal medical therapy, ejection fraction ≤35%, and QRS duration ≥120 milliseconds (preferably ≥150 ms with left bundle branch block pattern). The device requires three leads: right atrial, right ventricular, and left ventricular (placed via the coronary sinus). Clinical benefits include improved quality of life, exercise capacity, and survival outcomes in appropriately selected patients.
Usage
Usage note: Distinguished from CRT-P (pacemaker only) by the addition of defibrillator capability for sudden death prevention.
In Context
- "The patient met criteria for CRT-D implantation based on EF of 25% and LBBB with QRS of 160 ms." — Electrophysiology consultation
- "Six months post CRT-D implantation, the patient showed significant improvement in NYHA class and EF." — Device clinic follow-up