Electrophysiologist Thomas Wannenburg, M.D., assistant professor of cardiology at Wake Forest University Baptist Medical Center, implanted a biventricular pacemaker live on the Internet Thursday, Feb. 17 at 5 p.m., and the webcast is now available for viewing at any time.
The Heart Center at Wake Forest Baptist was the first in North Carolina to offer patients with severe heart failure this device, the first approved for treating severe heart failure. On average, patients improve one point on the New York Heart Association Heart Failure Classification scale.
About the Procedure
The biventricular pacemaker synchronizes the heart’s two lower chambers, the ventricles, to improve pumping efficiency and relieve many symptoms of congestive heart failure. In this procedure the device also included a defibrillator.
The webcast includes video of the full implantation process; however, the webcast ends, due to time limitations, before the “live” procedure concluded. The electrophysiology team did successfully implant the final lead in an anterolateral branch about 10 minutes after the program ended. They then successfully performed defibrillation testing. The patient did well and was later discharged.
Implantation of the biventricular pacemaker or defibrillator takes about two hours on average. First, the physician injects local anesthesia and makes an incision about two to three inches long in the pectoral area to create a pocket for the device. Using a guide wire he will obtain access the cephalic or subclavian veins. Next, the physician maneuvers the leads into position in the heart. The device is connected to the leads and slipped into the chest through the incision. The device is then programmed and tested. Finally, the physician checks everything again and closes the incision.
Heart Failure Facts
- Heart failure is estimated to afflict approximately 5 million Americans.
- Heart failure is the most costly cardiovascular disease in the United States. Total cost of caring for U.S. heart failure patients is estimated to be about $40 billion per year and growing rapidly. Heart failure accounts for 5 to 10 percent of all hospital admissions.
- Heart failure accounts for nearly one million hospitalizations annually, resulting in 6.5 million hospital days, with an average cost of $11,000 per patient per hospitalization and an average stay of 6-8 days.
About the Procedure
The biventricular pacemaker is used to synchronize left ventricular septal and free wall activation to improve cardiac output in patients with heart failure and ventricular conduction abnormalities. Biventricular pacing systems can be incorporated into a pacemaker or defibrillator depending upon the patient’s clinical need.
Implantation of the biventricular pacemaker or defribrillator takes about two hours on average. First, the physician injects local anesthesia and makes an incision about two to three inches long in the pectoral area to create a pocket for the device. Using a guide wire he will obtain access the cephalic or subclavian veins. Next, the physician maneuvers the leads into position in the heart. The device is connected to the leads and slipped into the chest through the incision. The device is then programmed and tested. Finally, the physician checks everything again and closes the incision.