The clinical application of CRT-D in patients with chronic heart failure

Objective Cardiac resynchronization therapy (CRT) is a new approach for the treatment of patients with chronic heart failure and has been associated with improved cardiac function, while implantable cardioverter defibrillator (ICD) can effectively prevent sudden cardiac death. Nowadays, cardiac resynchronization therapy-defibrillator (CRT-D) has been used clinically. In this study, we aimed to summaries the clinical application of CRT-D.Methods Four drug-resistant heart failure patients with the history of ventricular tachycardia were enrolled. Three of them had dilated cardiomyopathy and 1 had ischemic cardiomyopathy. They were all with left ventricular bundle branch block, enlarged left ventricle and cardiac dyssynchrony confirmed by tissue Doppler imaging. All of them were attempted to implant CRT-D.Results All patients were successfully implanted with CRT-D. The left ventricle lead positioned in an epicardial cardiac vein as follows: posterior in 3 and posterolateral in 1. The defibrillation thresholds were no more than 20 J and no complications occurred.One week after CRT-D implantation, the left ventricular ejection fraction increased from 0.34 to 0.42.ConclusionsAlthough the implantation of CRT-D is rather complicated with some potential of complications, yet it is still feasible and safe. Based on the significant effects, patients with the indication for CRT and ICD have to receive CRT-D.