Do You Need A Pacemaker? Treatment Options For Congestive Heart Failure

Do You Need A Pacemaker? Treatment Options For Congestive Heart Failure

Keeping Pace With CHF

Congestive heart failure (CHF) is a chronic condition rising rapidly in America. With CHF, the muscles in the heart are damaged or weakened, so the heart can no longer pump blood effectively. Sometimes, the heart does not fill with enough blood to be pushed out to the entire body. In severe cases, the lungs fill with fluid and blood, causing a congestive effect. Congestive heart failure is a progressively worsening disease, and at some point, the heart needs support to work effectively. A pacemaker can help the heart pump blood better and more consistently, significantly improving the quality of life.

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Stages of congestive heart failure

There are 4 defined stages of congestive heart failure. In the first stage, there are no symptoms, but the patient is at risk of developing CHF if lifestyle changes are not initiated. In stage 2, heart failure is present but primarily asymptomatic. Fatigue, chest pain, and shortness of breath occur after intense physical activity. During stage 3, the patient is usually diagnosed with the condition and often experiences unpleasant symptoms, even at rest. This stage presents as leg swelling and an inability to perform physical activity. Stage 4 is the final stage of heart disease when advanced symptoms are unresponsive to treatment. In this case, emergency medical care is necessary.

Can a pacemaker help?

A medical device called a pacemaker is helpful during stages 2-4 of congestive heart failure. A pacemaker consists of multiple small wires called leads connected to a pulse generator. This generator recognizes when the heart is not pumping blood effectively and sends an electrical signal to correct the issue. Heart failure requires a biventricular pacemaker. As part of cardiac resynchronization therapy (CRT), this pacemaker connects to the heart’s ventricles. The pacemaker sends signals to help the heart chambers work more effectively. Some patients also need an implantable cardioverter-defibrillator (ICD) to help maintain the heart’s rhythm. Today’s pacemakers have special sensors to help with both issues and are even becoming leadless.

Pacemaker eligibility

A doctor will perform extensive tests at the various stages of heart failure. These tests will tell if a patient is an ideal candidate for a pacemaker. For example, stress tests can evaluate the heart’s electrical function and help determine the need for the device. Pacemakers are best for people with moderate to severe distress after physical activity. People with a low ejection fraction can also benefit from a pacemaker. The ejection fraction calculates how much blood is pumped out as a fraction of the total blood volume in the ventricle. Less than 50% ejection fraction is cause for concern, and a pacemaker can help.

Risks and benefits

Pacemakers are surgically installed during an outpatient procedure. The surgeon passes the leads through veins, then installs the pulse generator under the skin on top of the chest muscle. A fantastic benefit is that the heart works better, allowing patients to enjoy physical activities with fewer side effects. Pacemakers are also lifesaving devices, intervening quickly should the heart suffer distress. Best of all, pacemakers slow the progression of heart failure. Of course, with any procedure, there are risks. For example, complications while installing the pacemaker can occur. While using the device, the patient can suffer an infection, or the pacemaker can fail or move out of place. These complications are rare but require medical attention.

A better quality of life

Congestive heart failure is a distressing diagnosis. The heart gets progressively worse, and if left untreated, the patient’s lifespan reduces significantly. Regular health checks ensure doctors identify the issue early on. In some cases where the heart needs support, a pacemaker can help. By regulating electrical impulses and helping the heart work effectively, CHF patients can live longer.

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