Huntington Hospital was among the first Long Island institutions to perform cardiac resynchronization therapy when it became commercially available in 2002. Cardiac resynchronization therapy involves the implantation of a specialized type of pacemaker that restores a healthy heart rhythm, and at the same time reminds the heart’s lower chambers to beat in tandem, helping the heart to more efficiently pump blood throughout the body. It is used to treat patients who have advanced heart failure in which the heart’s lower ventricles do not work in tandem with each other. An estimated 650,000 Americans are believed to have this condition.

The healthy heart’s contractions are supposed to be powerful enough to force oxygen-rich blood to circulate throughout the entire body. Congestive heart failure, which affects up to five million Americans, occurs when the heart is too weak to adequately pump blood. Patients with congestive heart failure experience fatigue, shortness of breath, and fluid accumulation around the lungs. In some patients, the condition is further complicated by the failure of the heart’s two lower chambers to beat in synchrony.

“In this condition, an echocardiogram actually shows that when the right ventricle starts relaxing, the left begins pumping,” explained Paul Maccaro, MD, Chief of Electrophysiology at Huntington. “The heart begins swinging from side to side, like a pendulum, rather than squeezing blood out.”

The device is implanted during a procedure in the hospital’s Electrophysiology Laboratory. Wire leads are threaded through a catheter and attached to the right atrium and ventricle, areas where a traditional pacemaker’s wires are implanted. With this device, a third wire travels down to the right ventricle and snakes to the left ventricle. The device itself, which is the size of a silver dollar, is implanted under the skin in the chest. Shortly after the procedure, patients return to Dr. Maccaro’s office where a computer programs the pacemaker and it is turned on. Results can be seen and felt almost immediately.

Cardiac resynchronization therapy is intended for use along with medication therapy for patients with mild to severe heart failure.