A biventricular pacemaker is an electronic, battery-powered device that is surgically implanted under the patient’s skin who is suffering from advanced heart failure. The condition is considered advanced when conventional heart therapies and symptom management strategies no longer work. This special pacemaker is designed to treat the delay in heart ventricle contractions. This happens when the right and left ventricles do not pump together and the left ventricle is not able to pump enough blood to the body. The biventricular pacemaker keeps both ventricles pumping together by sending small electrical impulses through the leads. This instrument has helped to improve survival, quality of life, the ability to exercise and help decrease hospitalisation in selected patients.

What Happens Before the Pacemaker Implantation

• A letter of consent will obtained which allows the doctor to perform the procedure.  At this time, patients are free to ask any questions
• Patients are required to fast for 6-8 hours prior to the procedure
• If the patient is pregnant, she must notify the doctor
• Patients must inform the doctor if they are taking any blood thinning medications because they need to stop consuming them 5 to 7 days prior to the procedure
• Patients need to assure the doctor if they are fasting, have allergies to latex, iodine, medicine or any anaesthetic agents
• Patients need to notify the doctor about the current consumption of medication, herbs or supplements
• Patients who has a history of heart valve disease or surgery may need antibiotic prior to the procedure
• Patients need to have someone to drive them home after the procedure due to the effects of sedation

What Happens During the Pacemaker Implantation?

1. When the patient arrives at the hospital, he/she will be asked to remove all jewellery or objects (rings or watch) that can interfere with x-rays; he/she will also need to change into a hospital gown.

2. Once the patient arrives in the operating room, he/she will be asked to lie on a table. An intravenous access will be started in one of their arms and monitors will be placed to assess the subject’s heart rate, breathing, blood pressure and oxygenation.

3. Any excess hair around the left side of the chest will be shaved.

4. In most people, the procedure is done with the use of mild intravenous sedation and local anaesthetic.

5. The site where the pacemaker is inserted will be cleaned with antiseptic solution. Once the IV sedative is administered, the doctor will inject a local anaesthetic and then insert the pacemaker. The procedure is done using an X-rays to ensure that the lead is placed in the right position. Once the lead is placed, it will be connected to a generator which will then be placed in the left collar bone.

6. The pacemaker will be checked to ensure that it is working. The wound will be cleaned and closed. The patient will have a sling placed in their left arm for several days to ensure that the lead does not move

What Happens After the Pacemaker Implantation?

After the pacemaker is inserted, patients need to see the cardiologist who will conduct studies in determining the ideal heart rate for that particular person. The pacemaker can be programmed with an external device in a few minutes.

Recovery Room

After the procedure, the patient will be taken to the recovery room for observation for a few hours. Once they are stable, they will be sent back to the medical floor. Most patients stay overnight under observation. Before discharge, the doctor will check the patient’s pacemaker one more time to ensure it is working fine.

What Should I do at home?

• Patients can resume their daily activities within 2 days
• They should avoid physician activities and sports for at least 4 to 6 weeks
• Patients are instructed to limit their arm movement on the side where the pacemaker was inserted

• Keep the wound dry for at least 1 week

Is the Procedure Safe?

Pacemaker implantation is a very safe procedure. However, like any invasive procedure, there are potential risks which include:

• Bleeding
• Infection
• Air in the chest cavity (pneumothorax)
• Dislodgement of the lead

However, with experienced surgeons, the complication rate is very low.

What Precautions are Required After Pacemaker Insertion?

DO always carry an ID card or wear a medical that states you have a pacemaker

DO inform staff at security screeners (such as airport) that you have a pacemaker

DO protect the pacemaker site when performing physical activities

DON’T undergo an MRI unless there is a pacemaker which is compatible with the MRI

DON’T carry a cell phone in the pocket next to the pacemaker

AVOID magnets and similar devices

AVOID areas of high voltage, TV transmitters, high tension wires and radar installations

---

Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.