Cardiac Resynchronization Therapy (CRT)
Cardiac resynchronization therapy (CRT) uses a special pacemaker with leads to both lower chambers of the heart so they beat in a coordinated way. In selected people with heart failure and an electrical delay, it improves the heart's pumping efficiency, eases symptoms and can reduce hospital admissions.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
In some people with heart failure, the heart's lower chambers no longer contract together because of an electrical delay (such as left bundle branch block), which reduces pumping efficiency. CRT corrects this by pacing both lower chambers so they beat in sync — 'resynchronizing' the heart. The device is implanted much like a pacemaker, with an extra lead to the left side of the heart. It comes as CRT-P (a pacemaker) or CRT-D, which also includes a defibrillator to treat dangerous rhythms. It is offered to selected patients with reduced pumping function and an electrical delay whose symptoms persist despite the best medication.
International patients receive assessment, implantation and device programming, plus a plan for remote or local follow-up checks.
Who is a candidate?
- Heart failure with reduced pumping function (low ejection fraction)
- An electrical delay such as left bundle branch block or a wide QRS on the ECG
- Symptoms that persist despite optimal heart-failure medication
- Suitability for a device, sometimes combined with a defibrillator (CRT-D)
What happens
- 1
Preparation
Assessment includes an ECG and echocardiogram to confirm you will benefit; you may be asked to pause blood thinners and to fast before sedation.
- 2
During the procedure
Under local anesthetic and sedation, leads are guided through veins to the heart's chambers under X-ray, and the device is placed in a small pocket under the skin below the collarbone.
- 3
Afterwards
You stay overnight for checks and device programming, limit arm movement on that side briefly, and attend regular device follow-up appointments.
Benefits
- Re-coordinates the heart's pumping and improves efficiency
- Improves symptoms and quality of life
- Can improve heart function over time
- CRT-D adds protection against dangerous rhythms
- Monitored with regular clinic or remote checks
Risks & considerations
- Lead displacement needing repositioning
- Infection at the device pocket
- Bleeding or bruising
- Not everyone responds to CRT, and rarely a blood vessel or the heart can be injured
Conditions this treats
Where it is performed
This procedure is delivered by our Heart Center.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Cardiac Resynchronization Therapy (CRT) — frequently asked questions
CRT-P is a resynchronization pacemaker; CRT-D does the same but also includes a defibrillator that can stop a dangerous fast rhythm. Your cardiologist advises which is appropriate.
A standard pacemaker usually paces one or two chambers to prevent a slow heartbeat; CRT paces both lower chambers together to improve the pumping coordination in heart failure.
Many suitable patients have less breathlessness and better exercise tolerance, though not everyone responds; benefits often build over weeks to months.
The device is checked regularly in clinic or remotely to confirm it is working well and to adjust settings.
Your coordinator provides a transparent, itemized estimate, including whether a CRT-P or CRT-D is planned.
Related treatments
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