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Biventricular PAcemakers
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Biventricular PAcemakers

I have congestive heart failure with an EF of around 30-35%. I also have a permanent pacemaker.  My cardiologist and electrophysiologies have recommended a biventricular pacemaker because they say that a pacemaker in the right ventricle leads to asynchronous contractions and may be causing some decrease in function.  What are the indications of biventricular pacing?  What are the benefits and complications of the device?  How long have they been around and do we have any data about their reliability etc?   I understand they don't last as long as regular pacemakers.  I have been told that they are more difficult to implant but the electrophysiologist I go to is probably one of the best in our community.  Any other information I should know before I agree to this?  I don't want to get worse than I am right now.  I am on many drugs and would like to decrease them.  Thank you very much for any insight you can give me on this.
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rick,

thanks for the post.  

What are the indications of biventricular pacing? What are the benefits and complications of the device?

We are in the process of defining the exact indications. BIV pacing has shown wonders. For now, we tend to implant them in patients with heart failue, who have symptoms despite continued medical therapy. Especially those with evidence of contractile problems due to conduction disease. You pacemaker in the right ventricle gives you intrinsic dysfunction, and if you are having symptoms a BIV pacemaker may help.  At the Cleveland Clinic we have developed a whole section of electrical therapy for heart failure to further evaluate who benefits.

How long have they been around and do we have any data about their reliability etc?

Although not around as much as other pacemakers, I would assume them to be just as reliable. The downside is they do entail another pacing lead.

I understand they don't last as long as regular pacemakers. I have been told that they are more difficult to implant but the electrophysiologist I go to is probably one of the best in our community. Any other information I should know before I agree to this?

They can definitely be of benefit in people with heart failure symptoms. Most patients who do not get better, do not get worse. There are some technical issues with the implant so I would go to someone who does them frequently.


good luck!
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