CRT-D Implantation Treatment in India

Types of CRT-D Implantation Treatment India

Some of the types of CRT-D implantation are as follows:

• Epicardial CRT-D Implantation
• Transvenous CRT-D Implantation
• Cardiac Resynchronization Therapy with a Pacemaker (CRT-P)
• Cardiac Resynchronization Therapy with a Pacemaker and an ICD (CRT-D)
• CRT-D with Multi-Site Pacing (Multi-Site CRT-D)

Epicardial CRT-D Implantation

This procedure involves the placing of a CRT-D device on the surface of the heart through open-heart surgery. Epicardial implantation is typically considered when there are challenges with other types of lead placement or in some cases where the patient requires other heart surgeries.

Transvenous CRT-D Implantation

This is a less invasive procedure where the CRT-D device is implanted through blood vessels usually in the upper chest area and the leads are threaded through blood vessels into the heart chambers. Transvenous implantation is the more common approach and generally involves shorter recovery times as compared to epicardial implantation.

Cardiac Resynchronization Therapy with a Pacemaker (CRT-P)

CRT-P is a type of device used to treat heart failure. It combines the function of a pacemaker with the function of resynchronization therapy. The CRT-P device sends electrical signals to coordinate the contractions of the chambers of the heart and it helps to improve its pumping action.

Cardiac Resynchronization Therapy with a Pacemaker and an ICD (CRT-D)

CRT-D is a device that combines cardiac resynchronization therapy with both a pacemaker and an ICD function. It is used for patients who have heart failure with issues in the rhythm of the heart and are also at risk of life-threatening conditions.

CRT-D with Multi-Site Pacing (Multi-Site CRT-D)

In addition to the leads placed on the right side of the heart, Multi-Site CRT-D devices may include an extra lead on the left lower side of the heart. This approach helps in improving heart contractions even further.

Procedure of CRT-D Implantation

The general overview of the procedure of CRT-D implantation is as follows:

Anesthesia: The anesthesia is given to the patient to reduce the effect of pain and discomfort during the procedure. 

Incision: A small incision is made usually in the upper chest area and near the collarbone. 

Lead Insertion: One or more pacing leads are inserted through a vein and advanced to the heart. These leads are guided to specific locations within the heart chambers. The leads are then connected to the CRT-D device, which is usually placed under the skin beneath the collarbone.

Device Implantation: The CRT-D device is implanted in a pocket created under the skin, typically near the collarbone. Then the device is connected to the leads.

Testing and Programming: The device is tested to ensure proper functioning. The surgeon programs the CRT-D device settings to deliver appropriate treatment based on the specific heart condition of the patient.

Closure and Recovery: The incision is closed with sutures and a bandage is applied to the implantation site.

Cost of CRT-D Implantation in India

The cost of CRT-D implantation in India ranges from ₹ 12,72,000 to ₹ 15,54,000. The cost can vary according to the type of CRT-D device and its functions. The cost can also vary according to the complications of an individual patient.

Symptoms & Risk Factors of CRT-D Implant Treatment

Indications of CRT-D Implantation

Some of the conditions in which CRT-D implants are used are:

• Heart failure with reduced ejection fraction 
• Left bundle branch block 
• QRS duration greater than or equal to 150 milliseconds
• NYHA functional class II, III, or ambulatory IV
• Inadequate response to optimal medical therapy
• Recurrent ventricular tachycardia 
• Ventricular fibrillation 
• High risk of sudden cardiac death
• Ischemic cardiomyopathy
• Dilated cardiomyopathy
• Non-ischemic cardiomyopathy
• Ejection fraction
• Chronic atrial fibrillation
• Cardiac dyssynchrony
• Left ventricular dysfunction
• High-degree atrioventricular block
• Heart attack

Risk factors of CRT-D Implantation

Some of the risk factors that are associated with CRT-D implants are:

Surgical Risks

There can be complications related to the surgical procedure itself, such as infection, bleeding, or adverse reactions to anesthesia.

Lead Placement Complications

There can be problems with positioning or threading of leads within the heart which can result in perforation, dislodgment, or damage to blood vessels or heart structures.

Device-Related Complications

There is a risk of malfunctioning of the CRT-D device, lead fractures, or problems with electrical connections.

Infection

There is a risk of infection at the implantation site, which can lead to serious infection anywhere in the body.

Pneumothorax

There can be an accidental puncture of the lung lining during lead insertion that can lead to air accumulation in the pleural space.

Pericardial Effusion

There is a risk of accumulation of fluid in the sac surrounding the heart that can affect the heart function.

Blood Clots

There is a risk of formation of blood clots around the leads or device that can increase the risk of stroke or other complications.

Arrhythmias

There is a risk of abnormal heart rhythm that can worsen the condition of the patient.

Allergic Reactions

Some patients show allergic responses to device components, medications, or materials used during the procedure.

Recovery Issues

There can be complications of postoperative pain, discomfort, or delayed recovery from the implantation procedure.

Psychological Impact

There can be emotional and psychological challenges related to living with an implanted device.