Medical devices offer alternatives in the treatment for Congestive Heart Failure.

Congestive heart unfortunate (CHF) is a condition where the heart is not functioning properly due to the weakening of the heart muscle. As cardiac muscle is damaged, it looses it capability to squeeze strongly and causing a decreased output of blood flow and perfusion to the body and organs. Factors that lead to CHF are coronary artery disease (CAD), myocardial infarction (heart attack), congenital defects, infection, or toxic exposure.

In conjunction with medication, medical device companies that specialize in pacing and defibrillation systems offer biventricular cardiac resynchronization therapy (BiV-CRT) to help the functionality or squeeze of the heart. The leading companies in this technology are Medtronic, St. Jude and Guidant.

Traditional pacing/defibrillation systems consist of a single or dual lead system. The single lead systems have a ventricular lead and a device while dual lead systems consist of a ventricular lead, an atrial lead, and the device. Bi-ventricular systems have two leads to the ventricle and might or might not have an atrial lead.

The second ventricular lead in a BiV-CRT system is put through the coronary sinus vein, the vein that delivers unoxygenated blood form the heart into the atrium, and is positioned around the back of the heart to pace from the left side. Pacing form the left and right side synchronously grants for a more even squeeze. In CHF, the heart can’t squeeze evenly because of the enlarged heart muscle tissue. During ventricular contraction of a CHF patient the septum of the heart gets deviated to the right side and the output of the left side of the heart is weakened. Pacing from both sites decreases this deviation and can improve cardiac output.

Who is a good candidate for biventricular pacing? According to American Heart Association/American College of Cardiology/ North American Society of Pacing and Electrophysiology, guidelines for biventricular cardiac resynchronization therapy (BiV-CRT) devices are indicated for the reduction of the symptoms of moderate to severe heart unfortunate (NYHA Functional Class III or IV) in those patients who remain symptomatic despite stable, optimal medical therapy, and have a left ventricular ejection fraction < 35% and a QRS duration > 130 ms.

Just like with drugs, this therapy does not have the same affect for everyone. There are great success stories of moving patients form NYHA class IV to class II. This means that patients that were dependent on oxygen and unable to get up from bed were healthy to tolerate short walks without the use of oxygen after receiving BiV-CRT.