Why is this procedure done?
Heart failure happens when the heart has trouble pumping the right amount of blood through the body. When the pump is not working well, blood can back up into the lungs. This may cause swelling in the legs or other parts of the body. ‚
Heart failure is a long-term problem which may get worse over time. Work with your doctors to treat heart failure to keep it from getting worse. ‚
There are some medical devices to help the pumping action of the heart like: ‚
- Biventricular pacemaker ¢ ˆ ’ This device sends electrical signals to allow the heart to pump with a more regular rhythm to help blood flow out to the body.
- Left ventricular assist device ¢ ˆ ’ This is also called a LAVD. It helps the heart pump blood to the rest of the body.
- Implantable cardioverter defibrillator ¢ ˆ ’ This is also called an ICD. It helps keep the heart beating in a more normal pattern to help pumping.
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What will the results be?
- The heart will work better than it did.
- You will feel better and be able to do some activities you could not do.
What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- Chest x-ray
- Ultrasound
- Electrocardiogram (ECG)
- A cardiac cath to check the blood flow to your heart muscle.
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
- When you are asleep, the doctors put a tube in your mouth to help you breathe. They also put another small tube in your nose to your stomach to drain out any food or fluid during surgery. You will have a tube in your bladder to drain urine.
- The doctors will watch your blood pressure, heart rate, and breathing closely during the procedure.
- Biventricular pacemaker:
- Your doctor will make a cut near your collarbone. The doctor will put the lead wires into a vein that leads to your heart. The doctor will use x-ray images to see and guide the wires.
- There are three lead wires to be put into the heart. The first wire is attached to the upper right part of the heart. The second wire is attached to the lower right part of the heart. The third wire is attached to the lower left part of the heart. The other ends of these wires are connected to the small generator placed under the skin in your chest.
- Left ventricular assist device:
- The doctor will make a long cut in the center of your chest so that the heart can be seen. A heart and lung bypass machine will be connected. This machine will act as your heart and lungs as your heart will need to be stopped for the surgery. The doctor will put the pump under your skin in the upper part of your belly and connect it to your heart. Once the pump starts to work, your heart will start again. You will be taken off the heart-lung machine.
- Implantable cardioverter defibrillator:
- The doctor will make a cut below your collarbone to put a wire into the heart. An x-ray machine is used to watch the movement of the wire. The signals between the heart and the defibrillator are carried through this wire.
- The doctor will make a pocket under your skin. The defibrillator is placed into the pocket.
- The doctor will test the defibrillator before finishing the procedure.
What happens after the procedure?
- You will go to a Recovery Room where the staff will watch you closely.
- You will be given drugs to help with pain. Your blood pressure, heart rate, and breathing will be checked often.
- Your length of stay will depend on the type of procedure you had done.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Take your drugs as ordered by your doctor.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
What follow-up care is needed?
- Your doctor will ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- Your doctor may send you to a cardiac rehab center for more care.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- If you have a pacemaker, your doctor may ask you to make visits to the office within 6 weeks after the procedure to check on your progress. Be sure to keep these visits.
What lifestyle changes are needed?
- Keep your blood pressure, cholesterol, and high blood sugar under control.
- If you have a pacemaker or defibrillator:
- Remember that you will have special needs when you travel through airport security.
- Tell other doctors that you have a pacemaker or defibrillator.
Will physical activity be limited?
Your physical activity will be limited until your wound fully heals. Ask your doctor about the right amount of activity for you. ‚
What problems could happen?
- Infection
- Bleeding
- Device does not work the right way
When do I need to call the doctor?
- Signs of heart failure. These include trouble breathing, fast heartbeats, coughing, swelling of the belly and feet.
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine or not able to pass urine, wound that will not heal, vaginal itching or pain.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
Helpful tips
- The battery life of the pacemaker is 6 to 8 years.
- Join a support group. Learn how others have coped with this health problem.
- Talk with your doctor about your worries and fears.
Where can I learn more?
National Heart, Lung, and Blood Institute ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/hf/ ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/vad/ ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/ht ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/icd/ ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/pace/howdoes.html ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚