Biventricular pacemaker placement

A biventricular pacemaker (say "by-ven-TRICK-yuh-ler") is a device used to treat heart failure. Treatment that uses this type of pacemaker is called cardiac resynchronization therapy (CRT).

When you have heart failure, the lower chambers of your heart may not pump at the same time. The pacemaker sends painless electrical signals to your heart. These signals make the chambers pump at the same time. This can help your heart pump blood better and help you feel better.

Your pacemaker may be combined with an ICD, or implantable cardioverter-defibrillator. It can control abnormal heart rhythms. This can prevent sudden death.

You will get medicine to help you relax and prevent pain. The doctor will make a cut in the skin just below your collarbone. The cut may be on either side of your chest. The doctor will put the pacemaker leads through the cut. The leads go into a large blood vessel in the upper chest. Then the doctor will guide the leads through the blood vessel into different chambers of the heart. The doctor will place the pacemaker under the skin of your chest. The leads are attached to the pacemaker. Then the cut will be closed.

The procedure may take about 2 or 3 hours. You may need to spend the night in the hospital.

Pacemaker batteries may last about 10 years. Your doctor will tell you how often you will need to have your pacemaker and battery checked.

You can likely return to many of your normal activities after your procedure. You will need to be careful with certain electric devices. You will be given more information after getting your pacemaker.

If you are worried about having a pacemaker, it may help if you learn about how the pacemaker helps your heart. Talk to your doctor about your concerns.

You will get medicine before the procedure. This helps you relax and helps prevent pain.

The doctor makes a cut in the skin just below your collarbone. The cut may be on either side of your chest. The doctor will put the pacemaker leads through the cut.

The leads go into a large blood vessel in the upper chest. Then the doctor will guide the leads through the blood vessel into different chambers of the heart.

The doctor will place the pacemaker under the skin of your chest. The doctor will attach the leads to the pacemaker. Then the cut will be closed.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired.
• Be active. Walking is a good choice.
• Do not raise your arm (on the side of your body where the pacemaker is located) above shoulder level until your doctor says it's okay. This helps keep the pacemaker and leads in place while you heal. Your doctor may recommend gentle range-of-motion exercises for your shoulder.
• For at least 3 or 4 weeks, or for as long as your doctor says, avoid activities that strain your chest or upper arm muscles. This includes mopping floors or pushing a lawn mower or vacuum. It also includes swinging a golf club or tennis racquet or swimming.
• You may need to take about 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.
• Ask your doctor when you can drive again.
• Ask your doctor when it is okay for you to have sex.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.

Incision care

• If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
• You may shower 24 to 48 hours after surgery. Pat the incision dry. Don't swim or take a bath for the first 2 weeks or until your doctor tells you it is okay.
• You will have a dressing over the incision. A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.

Other instructions

• Keep a medical ID card with you at all times that says you have a pacemaker. The card should include the manufacturer and model information.
• Wear medical alert jewelry stating that you have a pacemaker. You can buy this at most drugstores.
• Tell all of your doctors, dentists, and other health professionals that you have a pacemaker before you have any test, procedure, or surgery.
• Ask your doctor for a list of electric devices that you might need to keep a short distance from your pacemaker.
• Check your pulse as directed by your doctor.
• Have your pacemaker checked as often as your doctor recommends. In some cases, this may be done from your home. Your doctor will give you instructions about how to do this.