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Biventricular Pacemaker
Aug 21st 2008
Biventricular
pacemakers
are special, very sophisticated pacemakers that are utilized in patients with congestive
heart failure. Unlike regular pacemakers that treat slow heart beats,
biventricular pacemakers are used only in patients with heart failure to
improve their functional capacity. “Normal” pacemakers usually stimulate the
right sided chambers of the heart to contract. Stimulation of the right side of
the heart does result in contraction of the right and left sides of the heart
as the electrical system travels throughout the heart from any focus of
stimulation. Biventricular pacemakers, however, stimulate both the right and
left ventricles of the heart, or pumping chambers of the heart. Rather than
allowing the electrical system to “spread naturally” when stimulated from the
right side, they cause the right and left side to contract in a coordinated
manner that has been shown in scientific studies to improve heart function.
This can result in significant improvement in a patient’s ability to remain
active without symptoms of heart failure such as breathlessness.
The biventricular pacemaker generally utilizes three
leads instead of the usual one or two for “regular” pacemakers. The primary
difference is that the “extra” lead is implanted in a position that allows for
direct stimulation of the left sided pumping chamber (ventricle). The method of
implantation is generally the same as a “regular” pacemaker, although the time
to implant the pacemaker may be longer as the positioning of the leads within
the heart is generally more time consuming. The procedure is generally
considered “minor” surgery using local anesthetic and sedation. Usually only one
night in the hospital is needed after implantation and patients are generally
back to normal activities quickly.
The types of patients that would benefit from a
biventricular pacemaker is an area of very active research. As always, whether
this is appropriate for any particular patient can only be determined through
an evaluation by the physician.