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.
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