Heart Center of Yuma -

For Resynchronization Therapy: Three Pacing Leads. Two leads pace the right atrium and right ventricle. The third lead, which is advanced through the coronary sinus into a venous branch that runs along the free wall of the left ventricle, allows early activation of the left ventricle.

BIVENTRICULAR PACEMAKER

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.

SYNCHRONIZING BEATS

While it 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 tolerate it.

EASY TO IMPLANT

So researchers 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.

IDEAL PATIENT

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 electrocardiogram.

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 excellent results.