Normally the heart’s electrical system makes both sides
of the heart contract at the same time. But imagine bits of your heart
not working together and beating at different times.
You might feel breathless, have difficulty getting around or exercising,
and you would fatigue easily. Because the walls of your heart were not
acting in concert, it would become less efficient, each beat pumping
only about a sixth of your heart’s normal volume.
might sound unlikely, this uneven pattern happens in about 25 percent of
all congestive heart failure patients. A promising new therapy,
biventricular pacing, was developed to help resynchronize beats by
sending electrical charges to the heart. Unlike a traditional pacemaker,
a biventricular pacemaker is hooked to both sides of the heart instead
of one, allowing the signal to reach both ventricles (pumping chambers)
at the same time.
Initially few patients were candidates for this kind of
resynchronization because the implantation surgery was too taxing on
already weakened systems. In the beginning this was done as an open
heart operation, so many patients with severe heart failure couldn’t
EASY TO IMPLANT
developed a less invasive implantation technique. A small incision is
made in the shoulder, and three electrical wires are threaded through
the vein to the heart. “The procedure is done under a local anesthetic.
It’s fairly easy to do the implant, although one wire is threaded into
an awkward place and that can take a few hours.
The ideal patient is
someone who has tried standard medical regimens (beta-blockers,
ACE-inhibitors, diuretics and usually digoxin) and is still breathless.
There must also be evidence of a weak heart and unsynchronized
contraction. If a patient does not have that, biventricular pacing will
not help.” Such a diagnosis is generally made after several tests by
your physician. Such tests might include an echocardiogram or cardiac
catheterization to reveal the poor heart function, and then possible an
LOOKING TO THE FUTURE
While the procedure is still new, several have been performed at Yuma
Regional Medical Center in the Heart Center of Yuma’s cath labs with