Biventricular Pacemaker

What is a biventricular pacemaker?

A biventricular pacemaker is an implanted device for people with advanced heart failure. It helps with abnormal heart rhythms (arrhythmias), like other pacemakers. The difference between a pacemaker and a biventricular pacemaker is the number of wires.

Instead of one or two wires (leads), a biventricular pacemaker has three. For lead placement, one goes to each ventricle (lower heart chamber). The third goes to your upper right heart chamber (atrium).

When your two ventricles don’t pump at the same time, your heart has a hard time getting enough oxygen-rich blood to your body. A biventricular pacemaker helps your heart work better because the ventricles beat at the same time. Healthcare providers call this treatment cardiac resynchronization therapy.

How does a biventricular pacemaker work?

Providers implant a biventricular pacemaker during an invasive procedure. The device has a pulse generator that contains a battery and a tiny computer. The leads connect to this to get the impulses.

The device sends electrical impulses during each heartbeat that make your two ventricles pump at the same time. These impulses pass through the leads to your heart’s chambers. Most people don’t feel the impulses.

Why would someone need a biventricular pacemaker?

You may need a biventricular pacemaker if:

• Heart failure medicines don’t help your symptoms
• Issues like fatigue and shortness of breath (dyspnea) hold you back during daily activities
• Your heart isn’t pumping as much blood as it should
• Your heart chambers don’t beat together
• You may be at a high risk for cardiac arrest

If you’re at risk for life-threatening heart rhythms, you may receive a biventricular pacemaker along with a defibrillator or ICD. This is a CRT-D, which isn’t the same as a biventricular pacemaker (CRT-P) alone. When the ICD detects a dangerously fast rhythm, it delivers a shock to stop it. The defibrillator in this device may protect you from sudden death due to dangerous arrhythmias.

What are the benefits of this device?

Benefits of a biventricular pacemaker may include:

• Improved symptoms
• Better quality of life
• Fewer heart-related hospital stays
• Improved heart function
• Longer survival with heart failure

What are the risks associated with a biventricular pacemaker?

Biventricular pacemaker surgery has risks like other procedures. Once in place, biventricular pacemakers have a risk of complications. A wire can move out of place or disconnect from heart tissue or the pulse generator. A device may also not function as it should.

Heart failure symptoms don’t improve in about 3 out of 10 people who get this device.

Are there reasons I can’t get this device?

You may not be able to get a biventricular pacemaker if you have:

• Active infection
• Bleeding disorder (trouble forming blood clots)
• Dementia
• Serious illness that may be fatal within a year
• Abnormalities in your central veins

How often do I need to see my healthcare provider?

With a biventricular pacemaker, you can expect to see your provider several times each year. They’ll want to check your health and make sure your device is working well. As it’s a machine, it may need a software update or a new battery now and then. You’ll most likely need to transmit remote check-ups of your device on a monthly basis.

How do I know if something’s wrong with my biventricular pacemaker?

If your device is having an issue, it might make beeping noises or communicate problems during a remote or in-person check. You may also feel symptoms you had before getting the device. Call your provider if you feel:

• Dizzy
• Faint
• Short of breath
• Shocks from your defibrillator

Are there devices I should stay away from with a biventricular pacemaker?

Yes. You should keep your distance from things that have a strong magnetic field. Being closer than 6 inches to it can stop your device’s signals. It may not be obvious to you if your device isn’t working right. If you do notice something, take some steps away from the cause of the problem. Even an electric fence for a dog could cause an issue.

Take care around devices like:

• Cell phones and headphones: You can use the speaker phone function or hold the phone to the ear on the side where you don’t have a pacemaker. Don’t carry your phone or headphones in your shirt pocket.
• Metal detectors: Your device can set this off. Show security staff your pacemaker ID card and ask for a special screening.
• Devices for medical or dental care: Talk to your provider before you have surgery, an MRI scan, kidney stone treatment, TENS for pain or radiation therapy for cancer.

How long can you live with a biventricular pacemaker?

The length of time you can live with this device depends on several factors. Your healthcare provider is the best person to give you an estimate. They may consider your age, other health issues you may have and how well the device is working for you.