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Biventricular Pacing

What is biventricular pacing?

Biventricular pacemakers are implantable devices that are used to synchronize the beating of the two ventricles of the heart. In the healthy beating heart both lower chambers (ventricles) beat together. The biventricular pacemaker is especially useful in the treatment of congestive heart failure in which the weakened ventricles of the heart become enlarged, and no longer beat together. Because the biventricular pacemaker is used to re-synchronize the rhythm of the ventricles, this treatment is called cardiac resynchronization therapy. Numerous studies have shown that cardiac resynchronization improves heart function, reduces symptoms, and prolongs life in patients with heart failure.

Patients with congestive heart failure may also have abnormalities in the electrical conduction system of the heart, which can lead to sudden cardiac death.  For this reason, biventricular pacemakers can be combined with implantable cardioverter defibrillators (ICDs) for patients at risk for life-threatening arrhythmias.

How is a biventricular pacemaker implanted?

Most biventricular pacemakers are now implanted under the skin in the chest. They consist of wires ("leads") which are inserted in a vein in the shoulder region or beneath the collar bone. Under x-ray guidance, the leads are advanced to the heart. To resynchronize the heart, one lead is placed into a vein in the heart which lies over the left ventricle; a second lead is placed in the right ventricle. These leads permit the device to detect the heart rhythm and deliver therapy.

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