Biventricular pacemaker implantation is a medical procedure done to delay the heart ventricle contractions. In the healthy heart, the upper heart chambers (atria) and the lower heart chambers (ventricles) pump the blood at the same time and in accordance with each other. When a patient has heart failure, these chambers lose their ability to pump blood together. When contractions between both the chambers do not match, the left ventricle is not able to pump blood properly to the body and thus pressure on the right ventricle to pump blood increases. Lack of coordination between atria and ventricles leads to heart failure symptoms such as shortness of breath, dry cough, fatigue, weight gain, frequent urination.

What is a biventricular pacemaker?

Biventricular pacemaker is implanted through a vein into the right ventricle and into the coronary sinus vein to control the left vein. Generally, a lead is also inserted into the right atrium to maintain the balance of the heartbeat. Pacemaker helps in the regulation of the right atrium and right ventricle and keep the atrium and ventricle working together.

Candidates of biventricular pacemaker implantation

Biventricular pacemaker reduces the symptoms of heart failure and is beneficial for the patient’s who have not shown any results with medications and other therapies. Suitable candidates of Biventricular pacemaker are:

• Patient with slow electrical activation of the heart
• Patients who are already taking medicines to treat heart failure
• Patients who have severe heart failure symptoms

Preparing for biventricular pacemaker implantation

• Patient should take medicines as prescribed by the doctors before undergoing biventricular pacemaker implantation.
• The patient should tell the doctor about their medical history and any procedure if they have ever undergone.
• Do not eat drink anything on the day of the procedure.
• Give up smoking and alcohol at least one month before the surgery. Tobacco consumption may slow down the healing process.
• A doctor may order a blood test to check if a patient is allergic to any medicine or anaesthesia.

Biventricular pacemaker implantation procedure

The surgeon will numb the area by injecting general anaesthesia. A cut is made to insert the pacemakers and leads. A fluoroscopy machine is used, which guides the lead inserted by the doctor into a patient’s vein. After this, lead is placed in the appropriate place and small amount of energy is delivered through the leads into the heart muscle, this process is known as pacing. Then lead is connected to the pacemaker and final pacemaker settings are made using a device called a programmer. The complete procedures take 2- 5 hours. After the implantation surgeon closes the incision with stitches.

After care of biventricular pacemaker implantation procedure

• Avoid taking shower and keep the wound clean and dry
• Take medicines as directed by the doctor
• Use an ointment with the dressing daily
• Avoid any regressive physical activity
• Avoid smoking and alcohol consumption