Multi-chamber pacemakers

Cardiac resynchronization therapy (Biventricular pace maker)

Multi-chamber pacemakers are special pacemakers that enable the ventricles to work synchronously and thus improve the symptoms of heart failure in some heart failure patients whose left and right ventricles do not work synchronously.

In a normal heart, the ventricles and atria work synchronously among themselves. If the electrical impulse is transmitted to the left ventricle late (left bundle branch block), the left ventricle’s blood pumping is also delayed, which aggravates the symptoms in patients with heart failure.

In patients with heart failure, if there is a conduction delay in the left heart, complaints of heart failure such as shortness of breath, dry cough, fatigue, swelling in the feet, and irregular rhythm increase.

Conventional pacemakers are used in the treatment of symptomatic patients whose pulse rate is below 40 per minute. Depending on the cause of low heart rate, leads are placed only in the right ventricle or right ventricle and right atrium. Pacemakers are adjusted to mimic normal heart physiology.

In multi-chamber pacemakers, the heart is stimulated from three separate chambers; as in normal pacemakers, there are right atrium and right ventricular leads. In multi-chamber pacemakers, the aim is to stimulate the heart from the left heart. is placed.

After successful biventricular pacemaker implantation, symptomatic improvement is observed in 50% of the patients. Echocardiographic examination shows 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 less than 30%, and symptomatic nonischemic cardiomyopathy under drug therapy are candidates for cardiac resynchronization therapy.

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