Biventricular Pacemakers
What is a biventricular pacemaker?
In a biventricular pacemaker, wires carry pulses to an atrium and both ventricles to coordinate the electrical signals between the ventricles.
When is cardiac resynchronization therapy necessary?
Cardiac resynchronisation therapy (CRT) is generally used in patients with severe heart failure who are experiencing a delay in heart ventricle contractions. When a delay in contractions occurs, the heart is much weaker than it should be and does not pump at its optimal rate. As a result, blood pumps through the body at a much slower rate than it should, increasing the pressure in the heart. At this point, the right and left ventricles are unable to contract at the same time.
What is cardiac resynchronization therapy?
During cardiac resynchronisation therapy, a biventricular pacemaker is implanted under the skin. The device has wires that are inserted through a vein in the right atrium and right ventricle and into the coronary sinus vein to reach the left ventricle. The wires are designed to regulate the rate at which the heartbeats.
How does it work?
If the wires in the pacemaker identify an irregular heartbeat, the generator sends small electrical pulses through the wires into the heart. These pulses cause the lower chambers of the heart to contract, allowing the left and right ventricles to pump together.
What are the benefits?
Benefits of cardiac resynchronisation therapy include:
- Improved quality of life
- Improved heart function
- Improved ability to exercise
- An improved survival rate in patients with moderate to severe heart failure
What happens at a pacemaker/ICD implantation procedure?
A CRT cardiac device is implanted by means of two approaches: An endocardial or epicardial procedure. Dr Thomas inserts leads through incisions in the chest, which he guides through the venous system into the heart. This entire method is made use of as well as fluoroscopy as a guide. Two of the leads move through the right atrium and ventricle, whereas the third pass through the coronary sinus and into the left ventricle. The tips connect to the heart while the other ends attach to the pulse generator. A generator is implanted beneath the surface of the skin in the chest area.