Biventricular ICD/Pacemaker ~ Cardiac Resynchronization Therapy (CRT)
A biventricular ICD (implantable cardioverter-defibrillator) or biventricular pacemaker device is an option for some patients with moderate to severe congestive heart failure. With heart failure, the heart is weakened and does not pump blood adequately to the body and organs. Frequently in heart failure, the lower heart chambers (ventricles) do not beat at the same time. With biventricular ICDs and pacemakers or cardiac resynchronization devices, the ventricles can be stimulated to work together. To accomplish this, three leads (soft insulated wires) are inserted through veins into the heart. These leads are connected to a small generator (about the size of a small stopwatch) that delivers tiny electrical pulses. The electrical pulses are sent to the two ventricles to make them contract at the same time. When the two ventricles beat together, the heart can beat as efficiently as possible to pump blood to the body. By improving the pumping function of the heart, heart failure symptoms may decrease. After the device is implanted, nurses from the ICD/Pacemaker Clinic at CentraCare Heart & Vascular are available to discuss concerns with you.  Before the Procedure - Do not to eat or drink anything for six to eight hours before the procedure. You may have sips of water to swallow your medications.
- Plan for someone to drive you to and from the hospital.
- Bring a list of all the medications you are currently taking. It is important to know the exact names and dosages of any medications that you take.
During the Procedure - Inserting a biventricular device is a minor surgical procedure that is done under local anesthesia. Most often, the device is inserted in the upper chest, near the collarbone. A local anesthetic is injected to numb the area where the device will be inserted. The doctor makes an incision below the collarbone and creates a “pocket” under the skin, where the pulse generator will be placed.
- The lead is then inserted through the chest incision and into a vein. With the help of an X-ray camera, the lead is guided through the vein and placed inside the heart. After a lead is in place, it is tested to ensure it senses the heart signals. The lead is then connected to the pulse generator. The pulse generator is programmed to treat your heart rhythm problem and placed in the pocket in your chest. The device is then tested to make sure it is working properly. Finally, the incision is closed and covered with a sterile dressing.
- You will be sedated during the procedure. Be sure to let the staff know if you feel any pain or discomfort. The procedure usually takes one to two hours.
After the Procedure - After your device is implanted, you will be taken to your room. A nurse will take your pulse and blood pressure and check the incision for bleeding or swelling.
- During your hospital stay, your heart rhythm will be continuously monitored.
- For a few days, it is normal to have some pain and stiffness around the incision. Do not raise the arm on the side of the incision above shoulder level, reach behind the back or stretch for four weeks.
- Ice may be applied during the first few days to decrease pain and swelling.
- Do not lift more than 10 pounds for four weeks.
- Most patients go home on the same day of the procedure. Prior to leaving, you will be given instructions about the care of the incision, physical activity, medications and restrictions.
- No driving for one week.
Recovering at Home You will probably be able to go back to most of your daily activities within a few days after leaving the hospital. However, it may take a few weeks before the incision is completely healed. Avoid getting the incision wet for seven days, then resume normal bathing. Do not touch the incision. For a few weeks, you may feel numbness or fullness in the area around the device — this is normal. You may also be aware of the pulse generator under the skin, but you will adjust to it over time.
Common Concerns - Pacemaker ID Cards: You will receive a temporary identification card before you leave the hospital, and a permanent card will be mailed to you soon after that. It is important to carry this card with you, especially when traveling. It identifies the company that made your pacemaker generator and lead wire.
- Traveling: You can travel without restriction. Airport screening devices are not likely to affect a pacemaker, but they may detect it. Have your Pacemaker ID Card available to show the attendant.
- Microwaves, Household Appliances and Power Tools: You may use all household appliances, this includes microwave ovens or power tools if they are properly grounded.
- High-Power Electrical Equipment: Avoid direct contact with high-power electrical equipment. Avoid direct contact or working with large running motors. You may drive any vehicle.
- Magnetic Resonance Imaging (MRI): It is not recommended for patients with pacemakers to have an MRI unless you have an MRI-safe device and wires. You will be able to have any other type of X-ray.
- Cell Phones and Mobile Devices: Keep these devices at least six inches from your pacemaker. Hold your cell phone to the ear opposite the side of your pacemaker. You should not carry a cell phone in a pocket or belt within six inches from your pacemaker.
- Magnet Therapy Items: Avoid magnet therapy items such as mattress pads, pillows, jewelry, soles for shoes, etc.
My Heart Group Meets June 16My Heart Support Group provides information to people, as well as their loved ones, who have heart conditions, specifically heart failure. At the meeting, you will find resources to take home, such as low-sodium food charts, recipes and other educational materials. The event also includes low-sodium snacks, drinks and drawings for door prizes. A speaker presents for most meetings with a focus on anything related to the diagnosis of heart failure. Any speaker who presents in St. Cloud will be broadcast to the My Heart Group at Melrose via the web. A facilitator at CentraCare – Melrose will lead table-top discussions on the subjects presented, serve low-sodium snacks and hold a door prize drawing. The meeting usually lasts around 1-1½ hours. The group meets at 3 p.m. on the third Tuesday of each month at CentraCare South Point, 3001 Clearwater Rd, St. Cloud, and CentraCare - Melrose, 525 W Main St. You may also join the meeting online. Video conferencing will allow Melrose and online participants to watch the speaker presentation in St. Cloud through Microsoft Teams. Guest Speaker To RSVP, email HFSupportGroup@centracare.com or leave a message at 320-470-0760. Indicate the number of guests and the location you would like to attend. |
