Cardiac Resynchronization Therapy In Heart Failure: Implant And Follow-Up Recommendations And Management

A careful evaluation of comorbidities and an estimate of life expectancy is recommended.

A thorough pre-implant history and physical examination including review of vital signs and laboratory tests is recommended.

CRT candidates should have stable heart failure status on guideline-directed medical therapy prior to implant.

A pre-implant comprehensive echocardiogram for quantification of LVEF and assessment of cardiac size and function is recommended.

A pre-implant 12-lead ECG including QRS duration measure (>120–130 ms) and characterization of QRS morphology is recommended.

In patients at high thromboembolic risk on oral anticoagulant therapy with warfarin, continuing therapy at reduced dosage with close monitoring of INR (INR 2–3) is recommended perioperatively. Post-operative use of heparin is discouraged.

Preoperative treatment with an antibiotic that has in vitro activity against staphylococci is recommended for infection prophylaxis.