Cardiac resynchronization therapy (Biventricular pace maker)
Multi-chamber pacemakers are used in some heart failure patients whose left and right ventricles do not work synchronously, which enable the ventricles to work synchronously and thus They are special pacemakers that improve the symptoms of heart failure.
In a normal heart, the ventricles and atria work synchronously among themselves. If the electrical stimulus is transmitted to the left ventricle late (left bundle branch block); the pumping of blood by the left ventricle is also delayed, which causes heart failure. It worsens the symptoms in patients.
In patients with heart failure, if there is a conduction delay in the left heart, heart failure complaints such as shortness of breath, dry cough, weakness, swelling in the feet, and irregular rhythm increase.
Conventional pacemakers. It is used in the treatment of symptomatic patients whose pulse rate per minute has fallen below 40. Depending on the cause of the low pulse, a lead is placed only in the right ventricle or in the right ventricle and right atrium. Pacemakers are adjusted to mimic normal heart physiology.
Multi-chamber heart In pacemakers, the heart is stimulated from three separate chambers; as in normal pacemakers, there are leads for the right atrium and the right ventricle. In multi-chamber pacemakers, the aim is to stimulate the heart from the left heart valve. For this, a third lead is placed in the vein that drains the side wall of the left heart via the main vein of the heart.
Symptomatic improvement is observed in 50% of patients after successful biventricular pace maker implantation. Echocardiographic examination shows a regression in the pumping function of the heart and mitral valve leakage.
Who is a candidate for cardiac resynchronization therapy:
Patients with left bundle branch block, ejection fraction below 30%, and symptomatic nonischemic cardiomyopathy under drug therapy are candidates for cardiac resynchronization therapy.
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