Chronische gelijktijdige stimulatie van beide hartkamers, een nieuwe behandelingsoptie voor ernstig hartfalen

- Dilated congestive heart failure due to systolic left ventricle dysfunction frequently leads to intraventricular conduction disturbances with a prolonged QRS complex (> 120 ms).

- The prolonged conduction time in the ventricles causes electrical asynchrony of the ventricles and contributes to a further reduction of systolic function, changes of filling and relaxation intervals, and promotes mitral valve insufficiency.

- Chronic simultaneous stimulation of both the right and left ventricle in patients with severe heart failure improves functional status, quality of life, and exertion tolerance.

- At present the implantation of a biventricular pacemaker is time consuming because the positioning of the lead in a left ventricular epicardial vein is difficult.

- As congestive heart failure is frequently associated with an increased risk of ventricular fibrillation, the combined implantation of a biventricular stimulator and an implantable automatic defibrillator is sometimes necessary.

- Preliminary calculations show that about 750 patients per year with severe congestive heart failure are eligible for a biventricular stimulator.