Living with Cardiac Resynchronization Therapy (CRT)

Your cardiac resynchronization therapy (CRT) device is also called a biventricular pacemaker. It was implanted to help coordinate the timing of (synchronize) your heartbeat and strengthen your heart. It needs special ongoing care. Part of this care may mean that you need to make some lifestyle changes. This sheet will tell you how to take care of the device and your health.

Checking your device

You’ll need to have your device checked about every 6 months. This will make sure it's working correctly and has plenty of battery life. This check will be done during visits to your healthcare provider or heart failure clinic. Or it may be done remotely from a special home monitor.

Newer devices are equipped with an antenna that can communicate with a remote monitor set up in your home. This allows information from your device to be sent to your healthcare provider via the internet or over a landline or cell phone connection. This remote monitoring system can be activated automatically or manually. It can reduce the need for frequent office visits to check your device.

Certain tests may be done to make sure the device is helping your heart as much as it can. These tests can include an electrocardiogram or echocardiogram (echo). From time to time, the device settings may need to be adjusted. This is done using an electronic wand placed over your device that sends information to a computer. Newer generations of devices don't need a wand. Instead, they can communicate wirelessly.

Replacing the battery

During your healthcare visits, your device’s battery level will be checked. If it’s low, there’s still plenty of time to replace the battery before it wears out. Most batteries in CRT devices last for several years. Newer systems last up to 10 years. Replacing the battery is a simple and quick outpatient procedure. The battery and computer in your chest are removed and replaced. Most often, the leads don't need to be replaced if they are working normally and will be connected to the new battery.

Staying away from certain other devices

Very few things can cause a problem with your device. CRT devices are well protected. Most machines and devices will not interfere with them. For instance, modern microwave ovens and other basic household appliances should not cause problems. Neither should computers, hair dryers, AM/FM radios, televisions, electric blankets, or cars.

A few things do create signals that could interfere with your implant device. These include:

• Electromagnetic anti-theft systems. These are often near entrances or exits in stores. Walking past, or through one is OK. But don’t stand near or lean against one.

• Strong electrical fields. Some things can generate strong electrical fields. These include radio transmitting towers and heavy-duty electrical equipment, such as arc welders. Stay away from these. A running engine also makes an electrical field. It’s OK to ride in a car. But don’t lean over the open hood of a running car.

• Cell phones and other electronics. Be careful when using cell phones and other electronic devices. Keep them at least 6 inches away from your CRT device. It's safest to hold all cell phones to the ear farther from your CRT device or use the speaker mode setting. Don’t carry your phone or electronic device in your chest pocket, over the CRT device. Experts advise carrying your cell phone and other electronics in a pocket or bag below your waist. Most cell phones and electronic devices don't interfere with CRT devices. But some cell phones and electronic devices, such as smart watches, use powerful magnets for wireless charging. These may interfere with the normal function of your CRT device. The magnet used for charging or other magnet accessories can also interfere with the normal function of your CRT device. These should be kept away from your CRT device when wirelessly charging or stored. Follow any other instructions given to you by your healthcare provider or from the manufacturer of your CRT device.

• Very strong magnets. Traditional pacemakers, CRT devices, and implantable cardioverter defibrillators are not compatible with MRI scanners and therefore are not recommended. Most new generations of these devices are compatible with MRI scanners.

In the rare case that an outside signal does affect it, it’s unlikely the device will be damaged. Typically, the signals will just cause interference. But you may want to have your healthcare provider check your device. If you ever suspect a problem, call your healthcare provider. Other things may interfere with your device. They might be in your workplace, a medical setting, or things you use in your leisure time. Your healthcare provider can review these items with you.

Carrying an ID card

Your device comes with an ID card. This contains important information about the device. You’ll be given a temporary card when the device is first implanted. A permanent card will be mailed to you. Show the ID card to any healthcare provider, dentist, and other medical professional you visit. Also show it to security guards at the airport and other secured areas like courthouses. This way, they know to use special procedures that prevent the security wand from causing a problem with your device.

Staying healthy

When CRT is effective at coordinating your heartbeat, you may have more energy. This makes it easier for you to stay active. Being active exercises your heart and can help you feel better overall. And keeping up with the other parts of your treatment plan can help you live longer and more comfortably. Talk with your healthcare provider about an exercise plan. When you are exercising, stop and call your healthcare provider right away if you feel any of the following symptoms.

• Chest pain or discomfort

• Burning, tightness, heaviness, or pressure in your chest

• Unusual aching in your arm, shoulders, neck, jaw, or back

• Trouble catching your breath

• A racing, slow, or skipping heartbeat

• Extreme tiredness (especially after exercise)

• Lightheadedness, dizziness, or nausea

• Symptoms of heart failure, such as rapid weight gain and swelling in your feet, legs, or belly (abdomen)

Call 911 if the symptoms don't go away quickly when you stop exercising, or if they occur while at rest.