Question: What is a biventricular pacemaker or cardiac resynchronization therapy (also called a CRT device), how is it implanted for heart failure patients, and who is a good candidate?
Answer: A biventricular pacemaker -- or resynchronization device -- is essentially a box or pacemaker that is implanted under the skin, near the shoulder. Wires then go into the heart. And those wires stimulate the heart to beat in a coordinated fashion. This treats the desynchrony associated with heart failure, and makes the heart beat more efficiently. The procedure itself is done very easily by electrophysiologists of cardiologists that implant the device. You don't know it's there, it's very seldom observed underneath the skin, and it really is something that one doesn't feel unless the device detects an irregular heart rhythm that is life-threatening, and then tries to get you out of that rhythm. Under conditions of a potentially life-threatening arrhythmia, the device will first try to pace the rhythm away. If that doesn't work, then it may deliver a shock to the heart. Depending on whether or not you are conscious, you may or may not feel that shock.