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Heart Disease  (Expert Forum)
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Biventricular Pacemakers
Answered by
Cleveland - OH
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests

Biventricular Pacemakers

by DottyCece, Sep 22, 2004 12:00AM
I have now been diagnosed with CHF.  My EF has declined from 50-55% to 30-35% I am on demadex, lisinopril, Coreg, amiodarone, KCL, Mag, etc.  I am still very symptomatic with SOB and fluid retention.  I do have a permanent pacemaker (VVIR) secondary to sick sinus syndrome and AV node ablation for Atr. Fib.  Cardiologist says I have a nonischemic cardiomyopathy (global hypokinesis on ECHO) probably secondary to asynchrony of contractions, two recent open heart surgeries, history of undiagnosed mitral valve regurg, and rapid heart rates over a prolonged period of time.  After a cardioversion and EP studies recently, the electrophysiologist is recommending biventricular pacing.  He was able to convert me to Sinus rhythm, rate of 40, and did get capture so he wants to revise the atrial lead (which has worked since surgery), and put in a left ventricular lead. I am also being evaluated for risks of sudden cardiac death and if that exists, he wants to put in the ICD integrated device.  

What I would like to know is what does the research show in terms of improving the heart failure situation, complications, and reliability of these devices.  I am not sure if he plans to use to guidant or medronic devices.  He is an expert who has implanted many of these devices since they have been on the market.  



I would be interested in any other information you may have on biventricular pacing.  Is there any information on the Cleveland Clinic web sites?  If so, what would I look for?  I have found some good research on medline but they are above my level of understanding.  Thanks.

by Cleveland Clinic, Sep 22, 2004 12:00AM
dotty,



thanks for the post.



We have seen pretty amazing results in some people with biventricular pacing, and alot of data supports definite improvement in symptoms. There isnt a gold standard to figure out who imporves, but generally those that dont improve do not get worse.



We have a center for the electrical treatment of heart failure in our electrophysiolgy section.



You could start here for more information.



http://www.clevelandclinic.org/heartcenter/pub/guide/tests/procedures/biventricular_pm.htm





hope this is a start
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