How CRT Helps Patients Stay Out of the Hospital
Rose Marie once struggled to walk to the mailbox. Medical device technology helps her and others feel healthier and stay out of the hospital.
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In a house filled with memories, Rose Marie Wilcher can think of only one she’d like to forget.
Because of it, she refuses to sit in one particular recliner.
“I don’t like to sit in it, it’s my husband’s chair now,” she said. “It represents how sick I was and I’m not that sick anymore.”
For nearly a year, Rose Marie slept sitting up in that chair, because when she laid in bed, she would choke and gag and feel as if she was drowning.
Constantly out of breath and out of energy, even a one-minute walk to the mailbox became a 20 minute ordeal. She could walk a few steps, but then had to stop to rest and catch her breath.
Originally diagnosed as asthma, more tests finally revealed something else.
“They said I had severe congestive heart failure,” she said. "I had an ejection fraction of about 10 percent, which you want to be in the 50s for normal. And also my heart was very enlarged.”
Cardiologist Marc Silver found an electrical problem with Rose Marie’s heart, causing it to beat out of sync and reducing its pumping efficiency to a fraction of what it should be.
Drug treatment didn’t help.
“She had EKG findings, in this case ‘left bundle branch block’ which is one of the major criteria for cardiac resynchronization therapy devices,” Dr. Silver said.
Similar in size to a pacemaker, cardiac resynchronization therapy (CRT) devices help get hearts back in sync and pumping efficiently again.
“At least two thirds to three quarters of patients who get the device feel better,” said Dr. Silver. “They can live fuller lives with less fatigue and less shortness of breath.”
Rose Marie went home the day after receiving her CRT device and started feeling better within a week.
Before her CRT, Rose Marie was among the one million Americans hospitalized every year with heart failure.
A quarter of a million of them require readmission within 30 days of leaving the hospital.
But studies are finding people with heart disease who receive CRT return to the hospital far less often than those without it.
Studies also find that versions of the device which incorporate Medtronic’s exclusive new AdaptivCRT™ algorithms reduce readmissions even further.
Yet it’s estimated that fewer than half of people eligible for CRT actually get a device, something Dr. Silver would like to see change.
“These devices improve survival. Fewer people die. People feel better. Fewer people get admitted. When they’re admitted they’re in the hospital for a shorter time,” he said.
Shorter stays and fewer readmissions are good news for hospitals, which face financial penalties if too many of their heart failure patients wind up back in the hospital.
According to the Centers for Medicare and Medicaid Services, in the fiscal year beginning October 1, 2015, 2,665 hospitals will lose a combined total of $420 million in penalties due to readmissions for five medical conditions, including heart failure. The total number of penalized hospitals is a record, and accounts for half of all U.S. hospitals.
Dr. Silver says the reduction in readmissions among patients with CRT is noticeable.
“Just this year, I can think of five or six patients who were in the hospital once a month who have not been in the hospital once since the device went in,” he said.
Rose Marie and husband Mike credit CRT with giving them a chance to do things together that not long ago seemed out of reach.
“I am so thankful for this. I really think it gave me my life back. I don’t think I would be here anymore if it wasn’t for that. It just feels so good to feel so much better that you want to do things,” she said.
Because even in a house full of memories, there’s always room for one more.
Important Information about CRT-ICD and CRT-Pacemaker Systems
A cardiac resynchronization therapy (CRT) implantable cardioverter-defibrillator (ICD) system delivers therapies to treat patients who may benefit from synchronizing the pumping of the heart chambers. A CRT ICD also delivers therapies to treat patients with heart rhythm disorders or who are at significant risk of developing heart rhythm disorders. A CRT ICD is placed inside your body and works automatically.
An implantable CRT pacemaker system relieves symptoms of heart rhythm disturbances. They do this by restoring normal heart rates. A normal heart rate provides your body with the proper amount of blood circulation. The pacemaker system is intended for patients who need rate-adaptive pacing or chronic pacing or for patients who may benefit from synchronizing the pumping of the heart chambers.
Risks associated with these implantable device systems include, but are not limited to, infection at the surgical site and/or sensitivity to the device material, failure to deliver therapy when it is needed, or receiving extra therapy when it is not needed. After receiving CRT ICD system, you will have limitations with magnetic and electromagnetic radiation, electric or gas powered appliances and tools in which you are allowed to be in contact.
Treatment with these implantable device systems is prescribed by your physician. This treatment is not for everyone. Please talk to your doctor to see if it is right for you. Your physician should discuss all potential benefits and risks with you. Although many patients benefit from the use of this treatment, results may vary. For further information, please call the Medtronic toll-free number at 1-800-551-5544 (7:00 a.m. to 6:00 p.m., Monday–Friday, Central Time) or see the Medtronic website at www.medtronic.com.