Heart failure is a condition that results from inadequate pumping of the heart and the inability of the heart to provide adequate circulation to the body’s vital organs. The most common cause of heart failure is heart attack, when the heart muscle is damaged due to a blockage in the heart arteries.
The heart function is measured as Ejection Fraction (EF) and the normal ejection fraction is between 65 – 70 %. “When the EF is < 45% patients develop heart failure, which is a very debilitating condition that causes marked limitation in physical activities. Severe heart failure occurs when the ejection fraction is < 35%. The prognosis from severe heart failure is worse than most cancers with the chance of survival at 5 years being less than 50%”, states Dr. Amal A Louis, Consultant Interventional Cardiologist. Patients with severe heart failure sometimes have “dyssynchrony” which is when the chambers of the heart don’t function in a synchronised manner causing further reduction in heart function.
Cardiac Resynchronisation Therapy (CRT) is a technique where the chambers of the heart are made to function in a synchronised mode using a special pacemaker. CRT -D is a device which provides Cardiac Resynchronisation Therapy using a pacemaker which also has a defibrillator to provide electric shocks to the heart when heart goes out of rhythm, thereby preventing sudden death.
A 61-year-old gentleman presented to Aster Hospital, Mankhool with a history of a heart attack in April 2019. He had severe heart failure subsequently with frequent episodes of fast and life-threatening heart beats. The patient’s ECG showed evidence of dyssynchronous heart function, after which he underwent Cardiac Resynchronisation Therapy with CRT-D implantation in October 2019.
The procedure was performed under local anesthesia where three wires were positioned inside the heart and connected to a pacemaker – defibrillator device (CRT-D device). This device can be programmed using a wireless programmer through which resynchronisation is achieved. The defibrillator will prevent the patient from passing suddenly due to life threatening heart rhythm disturbances.
“Following the device implantation, patients can lead a normal lifestyle including flight travel”, says Dr. Amal. Moreover, with Cardiac Resynchronisation Therapy, frequent fluid accumulation in the lungs can be prevented which thereby reduces the need for frequent hospitalisation.
Dr. Amal emphasizes, “Only a handful of centres in UAE have the expertise to perform this procedure and now Aster Hospitals can provide this service to eligible patients at an affordable cost.”