Biventricular Pacing

Overview

Congestive heart disease (heart failure) is a condition in which the heart does not pump hard enough, causing fluid to back up into the lungs.

Biventricular pacing is a promising new procedure that improves the left ventricle's ability to fully pump blood from the heart. As a result, patients are able to exert themselves more easily, live longer and have a higher quality of life.

Biventricular pacing works like a pacemaker. It synchronizes several actions of the heart to:

• Coordinate contractions of the left and right ventricles
• Reduce the amount of blood flow that leaks through the mitral valve
• Decrease the motion of the septal wall that separates the chambers of the heart (This motion can affect how much blood the left ventricle can pump out in a single beat)

The procedure uses a catheter to place electronic leads into the coronary sinus, the right ventricle and the right atrium. (The coronary sinus is a vein channel that leads from the largest of the cardiac veins. It receives most of the blood from the walls of the heart and empties into the right atrium, which is the upper, right chamber of the heart. The right ventricle is the lower, right chamber of the heart.) After the leads are replaced, the catheter is removed.

The next day, during follow-up echocardiography, the pacemaker is programmed to create the best span of time between the pumping of the atrium and the pumping of the ventricle to allow the ventricle to fully fill up.

There is a risk of setting off an uncontrollable, abnormal heart rhythm (ventricular tachycardia or fibrillation). However, the procedure offers many patients a significant improvement in the length and quality of their lives.