Biventricular Pacemaker Placement: Before Your Procedure

What is 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.

How do you prepare for the procedure?

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.

What happens on the day of the procedure?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
• The procedure may take about 2 or 3 hours.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your procedure.
• You become ill before the procedure (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the procedure.