Heart failure, a condition affecting millions, primarily occurs in older adults but can impact individuals of any age. It happens when the heart cannot pump enough blood, leading to symptoms like shortness of breath and fatigue. While heart failure can be managed with medications and lifestyle changes, some patients may require additional treatment options, such as permanent pacemaker implantation, to improve their heart function and quality of life.

A biventricular pacemaker is a device that helps coordinate the pumping action of the heart’s lower chambers (ventricles). Studies have shown that pacemaker implantation can significantly improve heart function and quality of life in patients with heart failure. According to a meta-analysis of clinical trials, biventricular pacemaker implantation has reduced the risk of heart failure hospitalisation by 37% and all-cause mortality by 24% compared to standard therapy.

This blog explores how this pacemaker implantation procedure can improve heart function.

What is Heart Failure?

Before delving into biventricular pacemakers, it’s important to understand heart failure. It is a progressive condition, different from a heart attack, where the heart gradually becomes less effective at pumping blood. 

This can occur due to various reasons, including damage to the heart muscle from a heart attack, high blood pressure, or other underlying health conditions. As a result, the body may not receive enough oxygen and nutrients, leading to symptoms such as fatigue, shortness of breath, and swelling in the legs and ankles.

What is a Biventricular Pacemaker?

A biventricular pacemaker is a type of cardiac device that is used to treat heart failure. Unlike traditional pacemakers, which only stimulate one side of the heart, biventricular pacemakers stimulate both the left and right ventricles of the heart. This helps to synchronise the contractions of the heart muscle, improving its efficiency and ability to pump blood effectively.

What Are the Indications for Biventricular Pacemaker Implantation?

The main indication for biventricular pacemaker implantation is heart failure with reduced ejection fraction and evidence of ventricular dyssynchrony. This therapy is for patients who still have symptoms despite treatment, have a low ejection fraction (35% or less), and show ventricular dyssynchrony on ECG. These criteria help identify patients who are most likely to benefit from biventricular pacing.

According to Dr Dinesh Mittal, biventricular pacemaker implantation is a game-changer for patients with specific types of heart failure. He emphasises that this therapy is particularly beneficial for individuals with persistent symptoms despite optimal medical treatment, a weakened left ventricle, and evidence of ventricular dyssynchrony. These criteria, as Dr. Dinesh explains, are crucial for identifying suitable candidates for this life-improving intervention.

How is Biventricular Pacemaker Implantation Performed?

The pacemaker implantation procedure typically involves the following steps:

• Preparation: The patient is prepared for the procedure, including anaesthesia
• Incision: A small incision is made in the chest near the collarbone
• Lead Placement: Leads are guided through veins into the heart chambers
• Pacemaker Placement: The pacemaker device is implanted under the skin near the collarbone
• Testing and Adjustment: The pacemaker is tested to ensure proper function and may be adjusted as needed
• Closing the Incision: The incision is closed with sutures or staples
• Recovery: The patient is monitored post-procedure and advised on aftercare

What Are the Benefits of Biventricular Pacemaker Implantation?

Biventricular Pacemaker Implantation offers the following benefits:

• Improved Heart Function: By synchronising ventricular contractions, biventricular pacemakers can improve the heart’s pumping efficiency, leading to better circulation and oxygenation of tissues.
• Symptom Relief: Patients often experience a reduction in symptoms such as fatigue, shortness of breath, and swelling in the legs.
• Quality of Life: Studies have shown that biventricular pacemakers can improve quality of life scores in patients with heart failure.
• Reduced Hospitalisations: CRT has been associated with a decrease in heart failure-related hospitalisations, which can improve patient outcomes and reduce healthcare costs.

Dr. Dinesh highlights, “Biventricular Pacemaker Implantation provides notable advantages compared to traditional pacemakers. Unlike traditional ones that stimulate only a single chamber, Biventricular Pacemakers concurrently stimulate both ventricles. This simultaneous activation enhances coordination and efficiency in heart contractions, offering significant benefits.”

A happy patient of Dr Dinesh shared, “I had been struggling with heart failure for years, and it seemed like nothing was helping. After getting a biventricular pacemaker implanted, my life changed. I have more energy, I can breathe better, and I feel like I have a new lease on life. I am so grateful to Dr. Dinesh and the team for recommending this procedure.”

Another satisfied patient stated, “Before my biventricular pacemaker implantation, I could barely walk up a flight of stairs without getting winded. Now, I can climb stairs, go for walks, and even play with my grandchildren without any trouble. It’s truly amazing how much of a difference this device has made in my life. Thank you, Dr. Dinesh, for giving me back my mobility and independence.”

What is the Cost of Biventricular Pacemaker Implantation in India?

Pacemaker implantation cost in India ranges from ₹3,00,000 to ₹6,00,000, approximately $4,000 to $8,000. However, this is a rough estimate, and the actual cost can vary. Several factors influence the final cost:

• Hospital
• Type of Pacemaker
• Location
• Surgeon’s Fee
• Duration of Hospital Stay
• Diagnostic Tests
• Post-Operative Care
• Insurance Coverage
• Complications
• Miscellaneous

Consulting healthcare providers and hospitals are advised to provide an accurate cost estimate based on individual circumstances.

Conclusion

Biventricular pacemaker implantation can be a valuable treatment option for patients with heart failure who have not responded adequately to other therapies. By synchronising the contractions of the heart muscle, biventricular pacemakers can improve heart function and quality of life for these patients. However, patients need to consult with their healthcare provider to determine if biventricular pacemaker implantation is the right treatment option for them.

FAQs

1. Is biventricular pacemaker implantation a permanent solution?

It depends on individual cases, but it can provide long-term benefits for many patients.

2. Can I lead a normal life after biventricular pacemaker implantation?

Yes, many patients return to normal activities within 1 to 3 months as heart function improves.

3. Are there any restrictions on physical activities after the procedure?

Initially, your healthcare provider may recommend avoiding strenuous activities, but most patients can resume normal activities over time.

4. Are there any dietary restrictions after biventricular pacemaker implantation?

Generally, there are no specific dietary restrictions, but maintaining a heart-healthy diet is recommended to support overall heart health.

5. What are the potential risks or complications of biventricular pacemaker implantation?

Potential risks include infection, bleeding, lead displacement, and device malfunction. However, these complications are rare, and your healthcare team will closely monitor you to minimise risks.

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