Implant of Biventricular Implantable Cardioverter Defibrillator also known as
cardiac resynchronization therapy defibrillator (CRT D)
Explanation of procedure
The aim of the biventricular implantable cardioverter defibrillator CRT-D is to treat support
your weak heart muscle by restoring helping the heart's pumping co-ordination and to look
for, monitor identify and, if required, treat any life-threatening heart rhythms. They CRT-D
devices can provide a range of treatments to correct abnormal heart rhythms including
electrical pacing for fast and slow electrical pacing heart rhythms and high energy
defibrillatorion shocks. The implant procedure involves inserting 3 wire(s)remove brackets
as we know they will have 3! (also called leads) into your heart through a vein just under
your collar bone. This is done with the help of X rays. The wire(s) are then connected to
the biventricular cardioverter defibrillator CRT-D battery box. An incision is made (usually
just below the collar bone, near where the vein that the wires are inserted into) and a
space is formed just below the skin to make a `pocket’. The box is put into a pocket made
under your skin in the same area. The placed into the pocket, which is then closed using
surgical stitches. The doctor may test the cardioverter defibrillator part of the device during
the procedure to ensure it is working correctly. This involves the delivery of 1 or more high
energy shocks while you are sedated.
The intended benefits of this procedure
To treat symptoms associated with your weak heart muscle so that you can do more and
experience fewer symptoms.
To look for and treat any abnormal fast and/or slow heart rhythms should they occur.
Serious or frequently occurring risks:
Less than 1 in 100 risk of serious or life threatening complications such as:
 blood clots which could cause a stroke or heart attack;
 puncture of the blood vessels or heart wall which could lead to a collection of blood
in the sac surrounding the heart and which could require an emergency operation to
repair.
2 in 100 risk of bleeding or bruising around the wound site which may require a tight
bandage overnight to control, removal of blood clots from around the box or removal of the
entire system. This risk is increased if you are taking blood thinners thinning medication.
2 in 100 risk of infection in or around the wound.
0-5 in 100 risk of a collapsed lung during the procedure.
10-15 in 100 risk of being unable to place a wire securely on the left side of the heart. This
may require a further surgical operation at a later date.
5-10 in 100 risk of the wire(s) moving out of position requiring a further procedure to reposition the wire(s) at a later date.
30:100 patients may experience no improvement in their symptoms of heart failure.
Any extra Additional procedures which may become necessary during or after the
procedure
Cardioversion or defibrillation. An electrical shock across the chest wall to restore a
normal heart rhythm.
I have discussed what the procedure is likely to involve, the benefits and risks of any
available alternative treatments (including no treatment) and any particular concerns of this
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patient.
□ Biventricular implantable cardioverter defibrillator (CRT D) patient information leaflet and
a wound care advice sheet have been given to you.
The
procedure will involve:
□ General anaesthesia
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□ Local anaesthesia
□ Sedation