A biventricular pacemaker can improve your health and quality of life if you have arrhythmia-related heart failure. The device coordinates contractions so that your heart’s lower chambers work together to efficiently pump oxygen-rich blood out to your body.
A biventricular pacemaker is an implantable device for people with advanced heart failure due to abnormal heart rhythms (arrhythmias) and/or function. The device consists of three wire leads and a pulse generator, which contains a battery and a tiny computer. Healthcare providers implant the device during a procedure.
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In a healthy heart, electrical signals help your left and right lower chambers (ventricles) pump together. With heart failure, abnormal signals cause ventricle contractions to fall out of synch. There may also be a lack of coordination with your heart’s right upper chamber (atria).
These issues reduce the number of effective contractions and therefore the amount of oxygen-rich blood pumped out to your body, making you feel sick. A biventricular pacemaker helps your heart work more efficiently. This treatment is also known as cardiac resynchronization therapy.
When there’s an abnormal rhythm, the device generates painless electrical impulses. They pass through the leads to your heart’s chambers, helping them pump together. Most people don't feel their heart pacing.
Candidates for a biventricular pacemaker are typically on heart failure medications but their symptoms continue worsening. They're likely at a high risk for cardiac arrest.
This treatment is also for people who have:
If you're at risk for life-threatening arrhythmias, you may receive a combined biventricular pacemaker and implantable cardioverter-defibrillator (ICD). When the ICD detects a dangerously fast rhythm, it delivers a shock to stop it. This device protects you from complications such as cardiac arrest and sudden death.
Healthcare providers implant the device through a small cut (incision) in your chest. There are two techniques for placing the wire leads:
What you feel depends on the lead placement approach:
The steps of the implantation procedure include:
Once the leads are in place, your healthcare provider performs lead function testing. This is also known as pacing. Pacing confirms that the leads are:
After successful pacing, your provider connects the leads to the device. Before completing the procedure, they set the device to meet your needs. After the implant procedure, your provider will make further adjustments as necessary. This is done by placing a programmer over the site of the generator.
A biventricular pacemaker improves symptoms of heart failure in about 50% of people who receive the device. Additional benefits include:
As with any heart failure treatment, biventricular pacemakers have a risk of complications. Potential complications include:
People typically start their recovery in the hospital.
Recovery can take a few months. You should rest and avoid strenuous activity involving your upper body during this time, especially on the side of the pacemaker implant.
You can also expect regular follow-up appointments with your healthcare provider to:
If treatment is successful, you may experience:
After your procedure, you should contact your healthcare provider if you have:
A note from Cleveland Clinic
A biventricular pacemaker is for people with moderate to severe heart failure symptoms. This device coordinates contractions of your heart’s lower chambers to improve heart function. Many people feel significantly better in the months following implant surgery.
Last reviewed by a Cleveland Clinic medical professional on 04/29/2022.
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