Biventricular cardiac pacemaker
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At the time the article was created Aneta Kecler-Pietrzyk had no recorded disclosures.View Aneta Kecler-Pietrzyk's current disclosures
At the time the article was last revised Joachim Feger had no recorded disclosures.View Joachim Feger's current disclosures
Biventricular cardiac pacemakers are surgically implanted cardiac conduction devices with one lead in each ventricle (and often one in the right atrium) used for cardiac resynchronization therapy.
On this page:
- lead in the right atrium
- lead in the right ventricle
- lead in the coronary sinus to pace the left ventricle
A biventricular pacemaker is generally used for cardiac resynchronization therapy in patients with severe heart failure who are not controlled well on maximal medical therapy and who have a prolonged QRS duration on ECG (i.e. bundle branch block). In bundle branch block, the affected conduction bundle delays conduction of the depolarization wave and thereby delays ventricular contraction. This means, for example, in the setting of a left bundle branch block the left ventricle will contract after the right, resulting in a broad QRS complex. Pacing leads are implanted into both ventricles and the device generates electrical impulses in order to stimulate both ventricles to contract simultaneously (and thereby improve the patient's symptoms and functional status).
It should not be confused with other implantable devices in the chest such as:
- 1. Heerey A, Lauer M, Alsolaiman F, Czerr J, James K. Cost Effectiveness of Biventricular Pacemakers in Heart Failure Patients. Am J Cardiovasc Drugs. 2006;6(2):129-37. doi:10.2165/00129784-200606020-00007 - Pubmed
- 2. Curtis A, Worley S, Adamson P et al. Biventricular Pacing for Atrioventricular Block and Systolic Dysfunction. N Engl J Med. 2013;368(17):1585-93. doi:10.1056/NEJMoa1210356 - Pubmed