Heart failure is a syndrome generally caused by a decrease in the ability of the ventricles to contract. However, in some patients with heart failure, the ventricles not only contract slightly, but also in a disorderly (desynchronized) way. It is easy to imagine that if, in addition to contracting little, they contract out of sync, the performance of cardiac function is further impoverished, making heart failure worse.
Cardiac resynchronization therapy seeks to solve intraventricular and interventricular desynchronization problems by means of pacemakers that stimulate both the right and left ventricles (biventricular pacemakers) so that both contract simultaneously, thus solving the problem. In this way, the biventricular pacemaker improves the symptoms of heart failure.
What is a cardiac resynchronizer?
A cardiac resynchronizer is a pacemaker that has one lead located in the right ventricle and one in the left ventricle. In this way, we can program that both electrodes receive a synchronized impulse, with which we achieve a synchronous movement of both ventricles.
In addition, we can implant an electrode in the right atrium to achieve synchronization of atrial and ventricular movement. This is called a triple chamber pacemaker.
For whom is Cardiac Resynchronization Therapy indicated?
Candidates for this therapy are patients with severe heart failure who also show signs of intraventricular dyssynchrony. These signs can be suspected simply by a simple electrocardiogram, in the presence of intraventricular conduction disorders such as left bundle branch block, and are confirmed by cardiac ultrasound.
What does the intervention consist of?
The procedure for implanting a resynchronizer is very similar to that of a conventional pacemaker , with the exception that an electrode must be accommodated in one of the cardiac veins that surround the left ventricle. This is achieved by means of guides and catheters after puncturing a vein that runs close to the clavicular region.