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<title>Cardiac resynchronization therapy</title>

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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Cardiac resynchronization therapy</span></span>

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</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Implanted cardiac resynchronization device</th></tr><tr><td colspan="2" class="infobox-image"></td></tr><tr><th scope="row" class="infobox-label"><a href="ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&srchtext=00.51&Submit=Search&action=search">00.51</a>, <a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&srchtext=00.54&Submit=Search&action=search">00.54</a></td></tr><tr><th scope="row" class="infobox-label"><a href="Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D058409">D058409</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="EMedicine" title="EMedicine">eMedicine</a></th><td class="infobox-data"><span class="reflink nourlexpansion"><a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/1839506-devices-overview">1839506-devices</a></span></td></tr></tbody></table>

<p><b>Cardiac resynchronisation therapy</b> (<b>CRT</b> or <b>CRT-P</b>) is the insertion of <a href="Electrode" title="Electrode">electrodes</a> in the left and right <a href="Ventricle_(heart)" title="Ventricle (heart)">ventricles</a> of the heart, as well as on occasion the right <a href="Atrium_(heart)" title="Atrium (heart)">atrium</a>, to treat <a href="Heart_failure" title="Heart failure">heart failure</a> by coordinating the function of the left and right ventricles via a <a href="Pacemaker" title="Pacemaker">pacemaker</a>, a small device inserted into the anterior chest wall.<sup id="cite_ref-:0_1-0" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p><p>CRT is indicated in patients with a low <a href="Ejection_fraction" title="Ejection fraction">ejection fraction</a> (typically <35%) indicating <a href="Heart_failure" title="Heart failure">heart failure</a>, where electrical activity has been compromised, with prolonged <a href="QRS_complex" title="QRS complex">QRS</a> duration to >120 <a href="Millisecond" title="Millisecond">ms</a>.<sup id="cite_ref-:1_2-0" class="reference"><a href="#cite_note-:1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>

</p><p>The insertion of electrodes into the ventricles is done under <a href="Local_anesthetic" title="Local anesthetic">local anesthetic</a>, with access to the ventricles most commonly via the <a href="Subclavian_vein" title="Subclavian vein">subclavian vein</a>, although access may be conferred from the <a href="Axillary_vein" title="Axillary vein">axillary</a> or <a href="Cephalic_vein" title="Cephalic vein">cephalic veins</a>. Right ventricular access is direct, while left ventricular access is conferred via the <a href="Coronary_sinus" title="Coronary sinus">coronary sinus</a> (CS).

</p><p>CRT defibrillators (<b>CRT-D</b>) also incorporate the additional function of an <a href="Implantable_cardioverter-defibrillator" title="Implantable cardioverter-defibrillator">implantable cardioverter-defibrillator</a> (ICD), to quickly terminate an abnormally fast, life-threatening heart rhythm. CRT and CRT-D have become increasingly important therapeutic options for patients with moderate and severe heart failure.<sup id="cite_ref-ChoiThomas2016_3-0" class="reference"><a href="#cite_note-ChoiThomas2016-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> CRT with pacemaker only is often termed "CRT-P" to help distinguish it from CRT with defibrillator (CRT-D).

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<div class="mw-heading mw-heading2"><h2 id="Indications">Indications</h2></div>

<p>The key indication for CRT is <a href="Left_bundle_branch_block" title="Left bundle branch block">left bundle branch block</a> (LBBB) of the heart, a cardiac abnormality leading to delayed left ventricular contraction. LBBB causes a <a href="QRS_complex" title="QRS complex">QRS</a> prolongation of ≥120 <a href="Millisecond" title="Millisecond">ms</a> on the <a href="Electrocardiography" title="Electrocardiography">electrocardiogram</a>, contributing to poor left ventricular coordination and reduced systolic function, thereby reduced ejection fraction (<35%). This reduction in ejection fraction is considered heart failure.<sup id="cite_ref-:1_2-1" class="reference"><a href="#cite_note-:1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>

</p><p>Heart failure patients are generally considered if in <a href="New_York_Heart_Association_Functional_Classification" title="New York Heart Association Functional Classification">New York Heart Association</a> (NYHA) class II or III heart failure. Current <a href="National_Institute_for_Health_and_Care_Excellence" title="National Institute for Health and Care Excellence">National Institute for Health and Care Excellence</a> (NICE) guidelines state that CRT-D device placement is inappropriate for class IV heart failure, but placement of CRT-P devices may be appropriate in certain circumstances.<sup id="cite_ref-NICE_2014_4-0" class="reference"><a href="#cite_note-NICE_2014-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Henin_2020_6-0" class="reference"><a href="#cite_note-Henin_2020-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

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<caption>NICE Guidelines for Treatment Options with ICD or CRT for Heart Failure Patients with Left Ventricular Dysfunction with an LVEF of 35% or less<sup id="cite_ref-NICE_2014_4-1" class="reference"><a href="#cite_note-NICE_2014-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

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<th>

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<th colspan="4">NYHA Class

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<th><b>QRS interval</b>

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<th>I

</th>

<th>II

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<th>III

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<th>IV

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<td colspan="3">ICD only if high risk of sudden cardiac death

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<td>Not indicated

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<th><b>120–149 milliseconds without LBBB</b>

</th>

<td>ICD only

</td>

<td>ICD only

</td>

<td>ICD only

</td>

<td>CRT-P

</td></tr>

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<th><b>120–149 milliseconds with LBBB</b>

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<td>ICD only

</td>

<td>CRT-D

</td>

<td>CRT-P or CRT-D

</td>

<td>CRT-P

</td></tr>

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<th><b>≥150 milliseconds with or without LBBB</b>

</th>

<td>CRT-D

</td>

<td>CRT-D

</td>

<td>CRT-P or CRT-D

</td>

<td>CRT-P

</td></tr></tbody></table>

<div class="mw-heading mw-heading2"><h2 id="Method">Method</h2></div>

<p>CRT requires the placement of an electrical device for biventricular pacing, along with placement of (at least) two pacing leads, to facilitate stable left ventricular and right ventricular pacing. For all elements, the first stage of the process is local anaesthetic followed by incision to allow for approach from the appropriate vein. From here, the leads and device can be inserted.<sup id="cite_ref-:0_1-1" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Right_ventricular_lead_placement">Right ventricular lead placement</h3></div>

<p>A <a href="Venipuncture" title="Venipuncture">venipuncture</a> is made, and a guide wire inserted into the vein, where it is guided, with use of <a href="Fluoroscopy" title="Fluoroscopy">real time X-ray imaging</a>, through to the right ventricle. The guide wire is then used to assist in the placement of the electrode lead, which travels through the venous system into the right ventricle where the electrode is embedded.<sup id="cite_ref-:0_1-2" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Left_ventricular_lead_placement">Left ventricular lead placement</h3></div>

<p>This is generally performed subsequent to RV lead placement, with the RV lead providing a backup in case of accidental damage to the <a href="Electrical_conduction_system_of_the_heart" class="mw-redirect" title="Electrical conduction system of the heart">electric fibers of the heart</a>, causing an <a href="Asystole" title="Asystole">asystolic event</a>. As with the RV lead, a guide wire is first inserted, allowing for the insertion of a <a href="Catheter" title="Catheter">multi-delivery catheter</a>. The catheter is subsequently maneuvered to the opening of the coronary sinus in the right atrium. From here a <a href="Contrast_agent" title="Contrast agent">contrast media</a> is injected, allowing the surgical team to obtain a coronary sinus <a href="Venography" title="Venography">phlebogram</a> to direct the placement of the lead into the most suitable <a href="Coronary_circulation" title="Coronary circulation">coronary vein</a>.<sup id="cite_ref-:0_1-3" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p><p>Once the phlebogram has been obtained, the multi-delivery catheter is used to guide in the lead, from the chosen vein of entry, into the right atrium, through the coronary sinus and into the relevant cardiac vein.<sup id="cite_ref-:0_1-4" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p><p>Left ventricular lead placement is the most complicated and potentially hazardous element of the operation, due to the significant variability of coronary venous structure. Alterations in heart structure, fatty deposits, valves and natural variations all cause additional complications in the process of cannulation.<sup id="cite_ref-:0_1-5" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> However, this risk can be reduced using AI-based<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> preoperative visualization of LV venous anatomy using computer tomography (CT) imaging.

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<div class="mw-heading mw-heading3"><h3 id="Device_placement">Device placement</h3></div>

<p>The device is inserted in a subcutaneous pocket created by the surgeon, the choice of left or right side of the chest wall is determined mainly by the patient's preference or location of preexisting device. The device, similar to that of a traditional <a href="Artificial_cardiac_pacemaker" class="mw-redirect" title="Artificial cardiac pacemaker">pacemaker</a>, is generally no larger than a pocket watch and has inserts for the electrode leads.<sup id="cite_ref-:0_1-6" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Benefits">Benefits</h2></div>

<p>Several studies have also shown that CRT can decrease mortality, reverse <a href="Ventricular_remodeling" title="Ventricular remodeling">left ventricular remodeling</a>, and improve quality of life, walking distance, and peak oxygen uptake (<a href="Vo2_max" class="mw-redirect" title="Vo2 max">VO<sub>2</sub> max</a>).<sup id="cite_ref-Leyva_2014_9-0" class="reference"><a href="#cite_note-Leyva_2014-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> A 2013 study showed that CRT improved the left ventricular ejection fraction (LVEF) by an average of 10.6% 12 months after placement.<sup id="cite_ref-Brambatti_2013_10-0" class="reference"><a href="#cite_note-Brambatti_2013-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Complications">Complications</h2></div>

<p>Key complications include:<sup id="cite_ref-:1_2-2" class="reference"><a href="#cite_note-:1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>

</p>

<ul><li>Dissection or perforation of coronary sinus which can in turn cause <a href="Pericardial_effusion" title="Pericardial effusion">pericardial effusion</a></li>

<li>Inability to cannulate coronary sinus (approximately 5% of patients)</li>

<li>Bleeding and pocket haematoma, each of which with an incidence of less than 1%<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup></li>

<li><a href="Cardiac_muscle" title="Cardiac muscle">Myocardial perforation</a>, <a href="Pneumothorax" title="Pneumothorax">pneumothorax</a> and <a href="Infection" title="Infection">infection</a>, all of which have an incidence of less than 1%</li></ul>

<div class="mw-heading mw-heading2"><h2 id="Technology">Technology</h2></div>

<p>Several research papers<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> have proposed software platforms for planning and guiding the implantation of CRT devices. This research proposes using pre-operative images to characterize tissue and left ventricle activation to identify potential target regions for deploying the CRT leads.

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<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/1839506-technique#c2">"Cardiac Resynchronization Therapy Technique: Approach Considerations, Placement of Pacing Leads, Programming of Device"</a>. <i>emedicine.medscape.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">17 July</span> 2018</span>.</cite></span>

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<li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><cite id="CITEREFNormandLindeSinghDickstein2018" class="citation journal cs1">Normand, C; Linde, C; Singh, J; Dickstein, K (2018). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jchf.2018.01.022">"Indications for Cardiac Resynchronization Therapy: A Comparison of the Major International Guidelines"</a>. <i>JACC: Heart Failure</i>. <b>6</b> (4): <span class="nowrap">308–</span>316. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jchf.2018.01.022">10.1016/j.jchf.2018.01.022</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/2213-1779">2213-1779</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29598935">29598935</a>.</cite></span>

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<li id="cite_note-Henin_2020-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-Henin_2020_6-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFHeninRagyMannionDavid2020" class="citation journal cs1">Henin, M; Ragy, H; Mannion, J; David, S; Refila, B; Boles, U (2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011924">"Indications of Cardiac Resynchronization in Non-Left Bundle Branch Block: Clinical Review of Available Evidence"</a>. <i>Cardiology Research</i>. <b>11</b> (1): <span class="nowrap">1–</span>8. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.14740%2Fcr989">10.14740/cr989</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1923-2829">1923-2829</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011924">7011924</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32095190">32095190</a>.</cite></span>

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<li id="cite_note-MimaBaba2010-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-MimaBaba2010_7-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFMimaBabaYokooKaichi2010" class="citation journal cs1">Mima, Takahiro; Baba, Shiro; Yokoo, Noritaka; Kaichi, Shinji; Doi, Takahiro; Doi, Hiraku; Heike, Toshio (2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898667">"Effective cardiac resynchronization therapy for an adolescent patient with dilated cardiomyopathy seven years after mitral valve replacement and septal anterior ventricular exclusion"</a>. <i>Journal of Cardiothoracic Surgery</i>. <b>5</b> (1): 47. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1186%2F1749-8090-5-47">10.1186/1749-8090-5-47</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1749-8090">1749-8090</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898667">2898667</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20525228">20525228</a>.</cite></span>

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<li id="cite_note-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-8">^</a></b></span> <span class="reference-text"><cite id="CITEREFSinitcaChmelevskyArduinoZubarev2023" class="citation book cs1">Sinitca, Aleksandr; Chmelevsky, Mikhail; Arduino, Chiara; Zubarev, Stepan; Shirshin, Aleksandr; Dokuchaev, Arsenii; Budanova, Margarita; Khamzin, Svyatoslav; Bazhutina, Anastasia; Rud, Sergei; Rainer, Werner (26 November 2023). <a rel="nofollow" class="external text" href="https://www.cinc.org/archives/2023/pdf/CinC2023-220.pdf">"A Machine Learning-Based Approach for Automatic Coronary Sinus Vein Segmentation and Anatomy Reconstruction"</a> <span class="cs1-format">(PDF)</span>. <i>2023 Computing in Cardiology Conference (CinC)</i>. Vol. 50. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.22489%2FCinC.2023.220">10.22489/CinC.2023.220</a>. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>979-8-3503-8252-5</bdi> – via IEEE Xplore.</cite></span>

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<li id="cite_note-Leyva_2014-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-Leyva_2014_9-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFLeyvaNisamAuricchio2014" class="citation journal cs1">Leyva, Francisco; Nisam, Seah; Auricchio, Angelo (2014). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jacc.2014.06.1178">"20 Years of Cardiac Resynchronization Therapy"</a>. <i>Journal of the American College of Cardiology</i>. <b>64</b> (10). Elsevier BV: <span class="nowrap">1047–</span>1058. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jacc.2014.06.1178">10.1016/j.jacc.2014.06.1178</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0735-1097">0735-1097</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25190241">25190241</a>.</cite></span>

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<li id="cite_note-Brambatti_2013-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-Brambatti_2013_10-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFBrambattiGuerraMatassiniCipolletta2013" class="citation journal cs1">Brambatti, M.; Guerra, F.; Matassini, M. V.; Cipolletta, L.; Barbarossa, A.; Urbinati, A.; Marchesini, M.; Capucci, A. (5 February 2013). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Feuropace%2Feus376">"Cardiac resynchronization therapy improves ejection fraction and cardiac remodelling regardless of patients' age"</a>. <i>Europace</i>. <b>15</b> (5). Oxford University Press (OUP): <span class="nowrap">704–</span>710. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Feuropace%2Feus376">10.1093/europace/eus376</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1099-5129">1099-5129</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23385052">23385052</a>.</cite></span>

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<li id="cite_note-11"><span class="mw-cite-backlink"><b><a href="#cite_ref-11">^</a></b></span> <span class="reference-text"><cite id="CITEREFAuricchioGaspariniLindeDobreanu2019" class="citation journal cs1">Auricchio, Angelo; Gasparini, Maurizio; Linde, Cecilia; Dobreanu, Dan; Cano, Óscar; Sterlinski, Maciej; Bogale, Nigussie; Stellbrink, Christoph; Refaat, Marwan M.; Blomström-Lundqvist, Carina; Lober, Christiane (September 2019). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jacep.2019.06.003">"Sex-Related Procedural Aspects and Complications in CRT Survey II"</a>. <i>JACC: Clinical Electrophysiology</i>. <b>5</b> (9): <span class="nowrap">1048–</span>1058. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jacep.2019.06.003">10.1016/j.jacep.2019.06.003</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31537334">31537334</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:201159537">201159537</a>.</cite></span>

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<li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><cite id="CITEREFMountneyBeharTothPanayiotou2017" class="citation journal cs1">Mountney, P.; Behar, J. M.; Toth, D.; Panayiotou, M.; Reiml, S.; Jolly, M. P.; Karim, R.; Zhang, L.; Brost, A. (November 2017). <a rel="nofollow" class="external text" href="https://kclpure.kcl.ac.uk/portal/en/publications/a-planning-and-guidance-platform-for-cardiac-resynchronization-therapy(005b962a-5811-45ec-9217-ba3b931983a3).html">"A Planning and Guidance Platform for Cardiac Resynchronization Therapy"</a>. <i>IEEE Transactions on Medical Imaging</i>. <b>36</b> (11): <span class="nowrap">2366–</span>2375. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1109%2FTMI.2017.2720158">10.1109/TMI.2017.2720158</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0278-0062">0278-0062</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28678701">28678701</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:3871779">3871779</a>.</cite></span>

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<li id="cite_note-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-13">^</a></b></span> <span class="reference-text"><cite id="CITEREFZhouHouPiccinelliTang2014" class="citation journal cs1">Zhou, Weihua; Hou, Xiaofeng; Piccinelli, Marina; Tang, Xiangyang; Tang, Lijun; Cao, Kejiang; Garcia, Ernest V.; Zou, Jiangang; Chen, Ji (December 2014). "3D fusion of LV venous anatomy on fluoroscopy venograms with epicardial surface on SPECT myocardial perfusion images for guiding CRT LV lead placement". <i>JACC: Cardiovascular Imaging</i>. <b>7</b> (12): <span class="nowrap">1239–</span>1248. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jcmg.2014.09.002">10.1016/j.jcmg.2014.09.002</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1876-7591">1876-7591</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25440593">25440593</a>.</cite></span>

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</ol></div></div>

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</style><div id="Tests_and_procedures_involving_the_heart388" style="font-size:114%;margin:0 4em">Tests and <a href="Medical_procedure" title="Medical procedure">procedures</a> involving the <a href="Heart" title="Heart">heart</a></div></th></tr><tr><td class="navbox-abovebelow hlist" colspan="2"><div>

<ul><li><a href="Cardiac_surgery" title="Cardiac surgery">Cardiac surgery</a></li>

<li><a href="Interventional_cardiology" title="Interventional cardiology">Interventional cardiology</a></li>

<li><a href="Cardiology_diagnostic_tests_and_procedures" title="Cardiology diagnostic tests and procedures">Cardiology diagnostic tests and procedures</a></li>

<li><a href="Cardiac_imaging" title="Cardiac imaging">Cardiac imaging</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Surgery</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Heart_valve" title="Heart valve">Heart valves</a><br>and septa</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Heart_valve_repair" title="Heart valve repair">Valve repair</a></li>

<li><a href="Valvulotomy" title="Valvulotomy">Valvulotomy</a></li>

<li><a href="Mitral_valve_repair" title="Mitral valve repair">Mitral valve repair</a></li>

<li><a href="Valvuloplasty" class="mw-redirect" title="Valvuloplasty">Valvuloplasty</a>

<ul><li><a href="Aortic_valvuloplasty" title="Aortic valvuloplasty">aortic</a></li>

<li><a href="Mitral_valvuloplasty" class="mw-redirect" title="Mitral valvuloplasty">mitral</a></li></ul></li>

<li><a href="Valve_replacement" title="Valve replacement">Valve replacement</a></li>

<li><a href="Aortic_valve_repair" title="Aortic valve repair">Aortic valve repair</a></li>

<li><a href="Aortic_valve_replacement" title="Aortic valve replacement">Aortic valve replacement</a>

<ul><li><a href="Ross_procedure" title="Ross procedure">Ross procedure</a></li>

<li><a href="Transcatheter_aortic_valve_replacement" title="Transcatheter aortic valve replacement">Transcatheter</a></li></ul></li>

<li><a href="Mitral_valve_replacement" title="Mitral valve replacement">Mitral valve replacement</a></li>

<li><a href="Transcatheter_pulmonary_valve_replacement" title="Transcatheter pulmonary valve replacement">Transcatheter pulmonary valve replacement</a></li></ul>

<dl><dt><span class="nobold">production of septal defect in heart</span></dt>

<dd><i>enlargement of existing septal defect</i>

<dl><dd><a href="Atrial_septostomy" title="Atrial septostomy">Atrial septostomy</a></dd>

<dd><a href="Balloon_septostomy" title="Balloon septostomy">Balloon septostomy</a></dd></dl></dd>

<dd><i>creation of septal defect in heart</i>

<dl><dd><a href="Blalock%E2%80%93Hanlon_procedure" title="Blalock–Hanlon procedure">Blalock–Hanlon procedure</a></dd></dl></dd></dl>

<dl><dt><span class="nobold">shunt from heart chamber to blood vessel</span></dt>

<dd><a href="Atrium_(heart)" title="Atrium (heart)">atrium</a> to <a href="Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a>

<dl><dd><a href="Fontan_procedure" title="Fontan procedure">Fontan procedure</a></dd></dl></dd>

<dd><a href="Left_ventricle" class="mw-redirect" title="Left ventricle">left ventricle</a> to <a href="Aorta" title="Aorta">aorta</a>

<dl><dd><a href="Rastelli_procedure" title="Rastelli procedure">Rastelli procedure</a></dd></dl></dd>

<dd><a href="Right_ventricle" class="mw-redirect" title="Right ventricle">right ventricle</a> to <a href="Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a>

<dl><dd><a href="Sano_shunt" title="Sano shunt">Sano shunt</a></dd></dl></dd></dl>

<dl><dt><span class="nobold">compound procedures</span></dt>

<dd>for <a href="Transposition_of_the_great_vessels" title="Transposition of the great vessels">transposition of the great vessels</a>

<dl><dd><a href="Arterial_switch_operation" title="Arterial switch operation">Arterial switch operation</a></dd>

<dd><a href="Mustard_procedure" title="Mustard procedure">Mustard procedure</a></dd>

<dd><a href="Senning_procedure" title="Senning procedure">Senning procedure</a></dd></dl></dd>

<dd>for univentricular defect

<dl><dd><a href="Norwood_procedure" title="Norwood procedure">Norwood procedure</a></dd>

<dd><a href="Kawashima_procedure" title="Kawashima procedure">Kawashima procedure</a></dd></dl></dd></dl>

<dl><dt><span class="nobold">shunt from blood vessel to blood vessel</span></dt>

<dd><a href="Systemic_circulation" class="mw-redirect" title="Systemic circulation">systemic circulation</a> to <a href="Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a> shunt

<dl><dd><a href="Blalock%E2%80%93Taussig_shunt" class="mw-redirect" title="Blalock–Taussig shunt">Blalock–Taussig shunt</a></dd></dl></dd>

<dd><a href="Superior_vena_cava" title="Superior vena cava">SVC</a> to the right <a href="Pulmonary_artery" title="Pulmonary artery">PA</a>

<dl><dd><a href="Glenn_procedure" title="Glenn procedure">Glenn procedure</a></dd></dl></dd></dl>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cardiac vessels</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<dd><a href="Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">Angioplasty</a></dd>

<dd><a href="Vascular_bypass" title="Vascular bypass">Bypass</a>/<a href="Coronary_artery_bypass_surgery" title="Coronary artery bypass surgery">Coronary artery bypass</a>

<dl><dd><a href="MIDCAB" class="mw-redirect" title="MIDCAB">MIDCAB</a></dd>

<dd><a href="TECAB" class="mw-redirect" title="TECAB">TECAB</a></dd></dl></dd></dl>

<dl><dt><span class="nobold"><a href="Coronary_stent" title="Coronary stent">Coronary stent</a></span></dt>

<dd><a href="Bare-metal_stent" title="Bare-metal stent">Bare-metal stent</a></dd>

<dd><a href="Drug-eluting_stent" title="Drug-eluting stent">Drug-eluting stent</a></dd></dl>

<dl><dt><span class="nobold">Obstacle removal</span></dt>

<dd><a href="Endarterectomy" title="Endarterectomy">Endarterectomy</a></dd>

<dd><a href="Atherectomy" title="Atherectomy">Atherectomy</a></dd></dl>

<ul><li><a href="Bentall_procedure" title="Bentall procedure">Bentall procedure</a></li>

<li><a href="Valve-sparing_aortic_root_replacement" title="Valve-sparing aortic root replacement">Valve-sparing aortic root replacement</a></li></ul>

<ul><li><a href="LeCompte_maneuver" title="LeCompte maneuver">LeCompte maneuver</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<dl><dt><span class="nobold"><a href="Pericardium" title="Pericardium">Pericardium</a></span></dt>

<dd><a href="Pericardiocentesis" title="Pericardiocentesis">Pericardiocentesis</a></dd>

<dd><a href="Pericardial_window" title="Pericardial window">Pericardial window</a></dd>

<dd><a href="Pericardiectomy" title="Pericardiectomy">Pericardiectomy</a></dd></dl>

<dl><dt><span class="nobold"><a href="Myocardium" class="mw-redirect" title="Myocardium">Myocardium</a></span></dt>

<dd><a href="Cardiomyoplasty" title="Cardiomyoplasty">Cardiomyoplasty</a></dd>

<dd><a href="Dor_procedure" title="Dor procedure">Dor procedure</a></dd>

<dd><a href="Septal_myectomy" title="Septal myectomy">Septal myectomy</a></dd>

<dd><a href="Ventricular_reduction" class="mw-redirect" title="Ventricular reduction">Ventricular reduction</a></dd>

<dd><a href="Alcohol_septal_ablation" title="Alcohol septal ablation">Alcohol septal ablation</a></dd></dl>

<dl><dt><span class="nobold"><a href="Cardiac_conduction_system" title="Cardiac conduction system">Conduction system</a></span></dt>

<dd>Maze procedure (<a href="Cox_maze_procedure" title="Cox maze procedure">Cox maze</a> and <a href="Minimaze_procedure" title="Minimaze procedure">minimaze</a>)</dd>

<dd><a href="Catheter_ablation" title="Catheter ablation">Catheter ablation</a></dd>

<dd><a href="Cryoablation" title="Cryoablation">Cryoablation</a></dd>

<dd><a href="Radiofrequency_ablation" title="Radiofrequency ablation">Radiofrequency ablation</a></dd>

<dd><a href="Artificial_cardiac_pacemaker" class="mw-redirect" title="Artificial cardiac pacemaker">Pacemaker insertion</a></dd>

<dd><a href="S-ICD" class="mw-redirect" title="S-ICD">S-ICD</a> implantation</dd>

<dd><a href="Implantable_cardioverter-defibrillator" title="Implantable cardioverter-defibrillator">ICD</a> implantation</dd>

<ul><li><a href="Left_atrial_appendage_occlusion" title="Left atrial appendage occlusion">Left atrial appendage occlusion</a></li>

<li><a href="Cardiotomy" title="Cardiotomy">Cardiotomy</a></li>

<li><a href="Heart_transplantation" title="Heart transplantation">Heart transplantation</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Tests</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<dl><dt><span class="nobold"><a href="Electrophysiology" title="Electrophysiology">Electrophysiology</a></span></dt>

<dd><a href="Electrocardiography" title="Electrocardiography">Electrocardiography</a>

<dl><dd><a href="Vectorcardiography" title="Vectorcardiography">Vectorcardiography</a></dd>

<dd><a href="Magnetocardiography" title="Magnetocardiography">Magnetocardiography</a></dd></dl></dd>

<dd><a href="Holter_monitor" title="Holter monitor">Holter monitor</a></dd>

<dd><a href="Implantable_loop_recorder" title="Implantable loop recorder">Implantable loop recorder</a></dd>

<dd><a href="Cardiac_stress_test" title="Cardiac stress test">Cardiac stress test</a>

<dl><dd><a href="Bruce_protocol" title="Bruce protocol">Bruce protocol</a></dd></dl></dd>

<dd><a href="Electrophysiology_study" title="Electrophysiology study">Electrophysiology study</a></dd>

<dd><a href="Wireless_ambulatory_ECG" title="Wireless ambulatory ECG">Wireless ambulatory ECG</a></dd></dl>

<dl><dt><span class="nobold"><a href="Cardiac_imaging" title="Cardiac imaging">Cardiac imaging</a></span></dt>

<dd><a href="Angiocardiography" class="mw-redirect" title="Angiocardiography">Angiocardiography</a></dd>

<dd><a href="Echocardiography" title="Echocardiography">Echocardiography</a>

<dd><a href="Myocardial_perfusion_imaging" title="Myocardial perfusion imaging">Myocardial perfusion imaging</a></dd>

<dd><a href="Cardiac_magnetic_resonance_imaging" title="Cardiac magnetic resonance imaging">Cardiovascular MRI</a></dd>

<dd><a href="Cardiac_ventriculography" title="Cardiac ventriculography">Ventriculography</a>

<dl><dd><a href="Radionuclide_ventriculography" class="mw-redirect" title="Radionuclide ventriculography">Radionuclide ventriculography</a></dd></dl></dd>

<dd><a href="Cardiac_catheterization" title="Cardiac catheterization">Cardiac catheterization</a>/<a href="Coronary_catheterization" title="Coronary catheterization">Coronary catheterization</a></dd>

<dd><a href="Cardiac_CT" class="mw-redirect" title="Cardiac CT">Cardiac CT</a></dd>

<dd><a href="Cardiac_PET" title="Cardiac PET">Cardiac PET</a></dd></dl>

<dl><dt><span class="nobold"><a href="Sound" title="Sound">sound</a></span></dt>

<dd><a href="Phonocardiogram" title="Phonocardiogram">Phonocardiogram</a></dd></dl>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cardiology_diagnostic_tests_and_procedures" title="Cardiology diagnostic tests and procedures">Function tests</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Impedance_cardiography" title="Impedance cardiography">Impedance cardiography</a></li>

<li><a href="Ballistocardiography" title="Ballistocardiography">Ballistocardiography</a></li>

<li><a href="Cardiotocography" title="Cardiotocography">Cardiotocography</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pacing</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardioversion" title="Cardioversion">Cardioversion</a></li>

<li><a href="Transcutaneous_pacing" title="Transcutaneous pacing">Transcutaneous pacing</a></li></ul>

</div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div><span class="noviewer" typeof="mw:File"><span title="Category"></span></span> Category</div></td></tr></tbody></table></div></div><div><div class="zim-footer">

This article is issued from <a class="external text" title="Last edited on 2025-07-23" href="https://en.wikipedia.org/wiki/?title=Cardiac_resynchronization_therapy&oldid=1302053142">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

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