FREQUENTLY ASKED QUESTIONS
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HOW IS A BIVENTRICULAR PACEMAKER OR DEFIBRILLATOR IMPLANTED?
During either pacemaker or defibrillator implantation, an extra “third wire,” also known as a left ventricular lead, is placed. This is threaded to the heart the same way as other pacemaker or defibrillator leads, except it is then further threaded from the right atrium into another vein that leads to the surface of the left ventricle. Getting that third wire in place is trickier but achievable in about 95% of cases. Otherwise, the rest of the procedures are the same as a standard pacemaker or defibrillator implantation. Please see the descriptions of those procedures.
Let’s look at the implantation details so you can know what to expect.
Understanding Biventricular Device Implantation
Before the implantation, you’ll undergo a series of tests to determine if you’re a suitable candidate for a biventricular device. Your doctor will review your medical history, perform a physical examination, and may order additional cardiac tests. You’ll receive specific instructions on how to prepare for the procedure, including guidelines on medication and fasting. It’s crucial to follow these instructions carefully to ensure the best possible outcome.
The procedure is typically performed under local anesthesia with sedation, meaning you’ll be relaxed but not fully unconscious. The cardiologist will make a small incision, usually just below your collarbone, to create a pocket under the skin where the device will be placed. Three thin wires, called leads, are then guided through veins into your heart using X-ray imaging for precise placement. These leads are connected to the right atrium, right ventricle, and left ventricle of your heart.
The most challenging part of the procedure is often placing the lead in the left ventricle. This lead must be threaded through the coronary sinus, a vein on the outer surface of the heart. Your cardiologist will use advanced imaging techniques to navigate this delicate process. Once all leads are in place, they’re tested to ensure they’re functioning correctly and providing the right level of stimulation to your heart.
After the leads are successfully placed, they’re connected to the pacemaker or defibrillator device. The device is then carefully positioned in the pocket created under your skin. Your doctor will test the entire system to make sure it’s working properly and programmed to meet your specific needs. This may involve adjusting various settings to optimize the device’s performance.
Once everything is in place and functioning correctly, the incision is closed with sutures. The entire procedure typically takes between two and five hours, depending on the complexity of your case and the type of device being implanted. After the procedure, you’ll be monitored in a recovery area to ensure there are no immediate complications.
If you’re considering a biventricular pacemaker or defibrillator or have questions about the implantation procedure, we encourage you to contact our Atlanta cardiologists. Our cardiac team specializes in advanced therapies and can provide comprehensive care throughout your treatment journey. From initial consultations to the implantation procedure and follow-up care, we’re committed to providing you with the highest-quality cardiac care.
Trust your heart health to CVG’s twenty board-certified cardiologists. Equipped with leading-edge diagnostic tools, a wealth of experience, and compassion, our cardiac team provides the highest level of personalized care.
You can review our cardiologists’ pages and explore their exceptional credentials and dedication to providing quality care. You can trust that our doctors genuinely care about you and will do everything they can to ensure you have the best quality of life possible.
To learn more, please call (770) 962-0399 or 678-582-8586. You may also request an appointment online. If you have an emergency, don’t contact us online; please call 911.