Cardiac Resynchronisation Therapy (CRT)

A conventional pacemaker has a wire in the right sided top chamber (right atrium), bottom chamber (right ventricle), or both. A CRT device has an additional wire to the other bottom chamber (left ventricle). This resynchronisation has been proven to significantly improve quality of life for those patients suitable for such a device. There is also some evidence it can prolong life. A CRT device can either be a pacemaker (CRTP), or combined with a defibrillator (CRTD) for those patient who need this type of device.

Conduction System Pacing (CSP)

A recent development in pacing has been the use of conduction system pacing (CSP). This uses a conventional one or two wire pacemaker, but the wire in the right ventricle is positioned to more accurately mirror the way that the electrical impulse normally moves through the heart. Implantation of a CSP device is a little more involved than for a conventional pacemaker and takes a little longer due to the need to position the pacing wire and perform specialist tests to ensure it will work in the right way. It’s not necessary for every patient who needs a pacemaker, but for some patients it can prevent deterioration of heart function over time so may be preferable to a conventional pacemaker. It can also be an alternative to CRT for those patients not suitable or who can’t have CRT for technical reasons.