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Biventricular Pacemaker

BIVENTRICULAR PACEMAKER (CRT PACING DEVICE)

Normally, the lower chambers of the heart (ventricles) pump at the same time and in sync with the heart's upper chambers (atria). When a person has heart failure, often the right and left ventricles do not pump together. And when the heart's contractions become out of sync, the left ventricle is not able to pump enough blood to the body resulting in an increase in heart failure symptoms, such as shortness of breath, dry cough, swelling in the ankles or legs, weight gain, increased urination, fatigue, or rapid or irregular heartbeat.

Biventricular Pacemaker, also known as Cardiac Resynchronisation Therapy (CRT), is used to treat the delay in heart ventricle contractions in some people with advanced heart failure. It is an electronic and battery-powered device which is surgically implanted under the skin. The device has 2 - 3 leads (wires)  positioned in the heart to help heart-beat in a more balanced way.  

WHO IS REQUIRED TO GET A CRT DEVICE?

Biventricluar Pacemaker or CRT Pacing Device may be recommended for people who:

  • Have Severe or moderately severe heart-failure symptoms
  • Are taking medications to treat heart-failure
  • Have delayed electrical activation of the heart (like  intraventricular conduction   
  • Delay or bundle branch block)
  • Have a previous history of cardiac arrest or who are at risk for cardiac arrest

HOW DOES BIVENTRICULAR PACEMAKER WORK?

The moment the heart-rate drops below the set-rate as programmed by the Cardiologist, the device generates small electrical impulses that pass through the leads to the heart muscle making the lower ventricles (chambers) of the heart muscle contract, causing the right and left ventricles to pump together resulting in  improved cardiac function.

BENEFITS OF CRT

CRT improves symptoms of heart failure in about 50% of patients  and improves survival, quality of life, heart function, ability to exercise, and helps decreasing the hospitalisation in select patients with severe or moderate heart failure.

CRT AND ICD THERAPY

Some patients with heart failure may benefit from a combination of CRT and an implantable cardiac defibrillator (ICD). The CRT/ICD combination devices resynchronise the heartbeat, lower down an abnormal fast heart rhythm, prevents abnormally slow heart rhythms and record history of the patient’s heart-rate and rhythm. Few CRT and ICD combination therapies have an inbuilt monitoring device so that the Doctor can track heart rhythm and heart function.  

DOES CRT IMPROVE THE EJECTION FRACTION (EF)?

Yes, CRT can help improve ejection fraction which  is the measurement of how much blood is being pumped out of the left ventricle of the heart. A normal EF ranges from 50%- 70%. People with heart failure who have a poor ejection fraction (EF<35%) are at risk for fast, irregular and sometimes life-threatening heart rhythms. The CRT/ICD combination device helps protect against these dangerous and fast heart rhythms.

IS THE DEVICE IMPLANT PROCEDURE SAFE?

 

It is generally a very safe procedure. Special precautions are taken to decrease the anticipated complexities.

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