CRT-D vs ICD decision

my father's lvef of 20-25%, got stented in 2017 after a heart attack. last week he had an episode of VT/VF. he is currently on meds on)

one doc suggested CRT-D implantation, other suggested ICD. the second one is a better doc overall.

I asked his assistant is that why not CRTD, she said they will do tests on admission to determine whats best for the patient (crtd or icd)

the admission and surgery is scheduled for monday by the second doc, I am worried that the doc will not even consider crtd

is it true that there are tests to decide the device type? and should I be concerned if this doc said ICD maybe he wont even attempt CRT-D?


4 Comments

Devices

by Lavender - 2024-01-05 23:07:33

The patient doesn't get to choose what device they need. The person installing the device makes that decision. I have a CRT-P that my EP decided upon with my cardiologist. I don't need an ICD. 

The HFA (heart failure assoc) guidelines state that if a patient is due to receive an ICD and has a QRS duration between 130 and 149 ms, a CRT-D should be considered, and if the QRS is ≥150 ms, a CRT-D is recommended.

I found this information online:
 

CRT Device:CRT devices are mainly used for patients with heart failure who also have evidence of ventricular dyssynchrony, as indicated by a prolonged QRS duration on an electrocardiogram (ECG).

ICD Device:ICD devices are typically recommended for patients at high risk of sudden cardiac death due to known or suspected ventricular arrhythmias.

Benefits: 

CRT Device: CRT can improve symptoms of heart failure, increase exercise tolerance, and reduce hospitalizations by improving the heart's pumping efficiency.

ICD Device:ICDs can deliver life-saving shocks to terminate dangerous arrhythmias and prevent sudden cardiac death.

Combination Devices: 

Some devices, known as CRT-D devices, combine both CRT and ICD functions. These devices provide resynchronization therapy for heart failure and also have the capability to deliver defibrillation shocks when needed.

CRT devices focus on synchronizing the heart's contractions to improve heart failure symptoms, while ICD devices are primarily aimed at preventing sudden cardiac death by detecting and treating life-threatening arrhythmias.

In some cases, both CRT and ICD functions are combined into a single device (CRT-D) to address multiple aspects of heart health. 

 

This one seems easy

by Good Dog - 2024-01-06 08:02:50

If his LVEF is in the 20% range and his condition requires a defib then a CRT-D seems like the one and only solution to remedy both of those problems. I don't understand why there is any doubt, but perhaps I am missing something? An ICD alone will do nothing for his heart failure. 

I am not a doctor and I certainly may be wrong. We have only a limited amount of info here that you provided. There may be much more that we do not know. That is why we have to leave it up to the Doc(s).

It would be great if you stop back in here to let us know the ourcome. 

I wish you nothing. but the best on the road ahead. I am sure the docs will get it sorted-out for you!

Sincerely,

Dave

Ecg

by kayjpr - 2024-01-06 09:02:17

the doc said as per ecg it seems crt wont be beneficial

I think he mentioned something about crtd being beneficial only if theres something something in left something, which is not the case as per ecg

bio

by new to pace.... - 2024-01-06 10:57:29

It would be helpful in our answers to you if you would at least fill in your location.  As where you live sometimes changes our answers in helping you.

new to pace

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