A special pacemaker implanted in the heart: All about the Biventricular Pacemaker

You may have heard doctors sometimes talk about a special device for someone whose heart function has become weak, that is, whose heart failure has become severe. There are times when medicine alone is not enough for those who find it difficult to breathe even with the slightest exertion and who feel tired all the time. That is when we need the help of this biventricular pacemaker.

Simply put, what is this biventricular pacemaker?

This is also a type of pacemaker that is implanted in the heart. But it is a little different from a regular pacemaker, and it does a special job. Usually, a pacemaker used to correct heart rhythm abnormalities (arrhythmias) has one or two wires. But this biventricular pacemaker has three wires (leads).

Now you might be wondering, "Why are there three wires?" It's very simple. Our heart has four main chambers. Two on top and two on the bottom. One of these three wires connects to the right atrium, the upper chamber of the heart, and the other two wires connect to the two ventricles, the lower chambers of the heart.

In severe heart failure, the two lower chambers of the heart do not contract at the same time or in the same rhythm. One contracts and the other does not. It's like two people working together, but instead of working together, they take turns. This makes the heart unable to pump blood efficiently throughout the body. This is when we feel tired and short of breath.

This biventricular pacemaker sends electrical signals to both lower chambers at the same time, causing them to contract together, in the same rhythm. This greatly improves the heart's pumping ability. Doctors call this treatment Cardiac Resynchronization Therapy , or CRT for short.

How does this device work?

This is a device that is implanted inside the body after a minor surgery. It has two main parts.

1. Pulse Generator: This is the part that looks like a brain. It has a battery and a small computer inside.

2. Leads: These are the three wires we talked about. These connect from the Pulse Generator to the appropriate chambers of the heart.

Every time the heart beats, this device sends out a very subtle electrical signal. This signal travels along the wire and causes the two lower chambers of the heart to contract at the same time. Most of the time, we don't even feel this electrical signal. But the heart's work is happening exactly as it should.

Who would need a pacemaker like this?

A doctor will look at several factors before recommending this device to you. The table below explains this further.

What are the benefits of installing this device?

There are many benefits to this. The main one is that it improves the quality of life.

• Reduction in symptoms: Things like fatigue and shortness of breath are significantly reduced.
• Improved quality of life: Daily tasks become easier and more convenient.
• Reduced hospitalizations: The need for frequent hospitalizations due to worsening heart conditions decreases.
• Improved heart function: The heart's ability to pump blood improves.
• Increased life expectancy: This helps you live a healthier life for longer, even with heart disease.

What are the risks of this?

As with any surgery, there are risks. Some complications can occur even after the device is implanted. For example:

• A fixed wire moving.
• The wire is removed from the heart or pulse generator.
• The device is not working properly.

Also, it's important to remember that not everyone who gets this device will get the same results. Roughly speaking, about three out of ten people who get it may not notice a significant difference in their symptoms. Talk to your doctor about this openly.

Can't everyone install this device?

Yes, there are times when some people cannot install this device. Here are some such cases:

• The presence of an active infection in the body.
• Having a bleeding disorder.
• Diseases such as dementia.
• Having another serious illness that could be fatal within a year.
• The presence of abnormalities in the main veins where the pacemaker wires are inserted.

Your doctor is the best person to decide whether this is right for you or not.

How do I know if there is a problem with the device?

Sometimes the device may make a beeping sound. Or your doctor may notice a problem during your monthly check-up. Apart from that, your body may also give you some signals. You should be especially concerned if the symptoms you had before the pacemaker are coming back.

What are the things to be careful about when living with a pacemaker?

Yes, this is very important. Basically, you need to stay away from things that have strong magnetic fields. Usually, it says to keep a distance of at least 6 inches. Because these magnetic fields can interfere with the signals from your pacemaker.

Things to be especially careful about:

• Cell phones and headphones: When talking on the phone, use speakerphone. Or hold the phone to the ear opposite the pacemaker. Never carry the phone or headphones in your shirt pocket.
• Metal detectors: Metal detectors at airports and shopping malls can set off alarms. Therefore, before entering, show your pacemaker ID card to security personnel and request a separate check.
• Other medical and dental treatments: This is extremely important. Whether you are seeing a doctor for any other condition or going to the dentist, the first thing you should tell them is that you have a pacemaker. It is especially important to inform your cardiologist before undergoing any procedures such as MRI scans, kidney stone treatments, TENS therapy for pain, or radiation therapy for cancer.

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