Biventricular devices / Cardiac Resynchronization Therapy

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A Biventricular Pacemaker (BiV) implantation, also known as Cardiac Resynchronization Therapy-Defibrillator (CRT-D) implantation, is a surgical procedure designed to improve the heart’s rhythm and symptoms associated with arrhythmia, particularly in patients suffering from heart failure. 

The device works by coordinating the contractions between the heart’s two ventricles, ensuring they pump blood into the body more efficiently. It also incorporates a defibrillator function which can deliver a shock to the heart in case of life-threatening arrhythmias, thus providing an added layer of protection.

The procedure is performed under local anesthesia with mild sedation for patient comfort. The CRT-D device, which is similar in size to a small pocket watch, is implanted under the skin in the upper chest area. Insulated wires, known as leads, are inserted into veins and guided into the heart using X-ray imaging. These leads are connected to the device and are positioned in three areas of the heart: the right atrium, the right ventricle, and the left ventricle, hence the term “biventricular.”

The CRT-D device continuously monitors the heart rhythm and delivers small electrical impulses to stimulate and synchronize the heart chambers if they are beating out of sync. It also acts as an automatic defibrillator if dangerous heart rhythms are detected, delivering a shock to restore a normal rhythm. 

While generally considered safe, the procedure does carry potential risks, including infection at the implant site, bleeding, damage to blood vessels or nerves, and rarely, puncture of the heart. 

After the procedure, the patient may need to stay in the hospital for a day or so for monitoring. Regular follow-up appointments will be necessary to check the device’s function and make any necessary adjustments.

BiV or CRT-D implantation can significantly improve quality of life and survival rates for individuals with specific types of heart conditions. However, it’s essential for patients to discuss the benefits and potential risks with their healthcare provider before proceeding with implantation.