Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein. You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Get the Compare Your Your Quiz Your Summary A pacemaker for heart failure is used for cardiac resynchronization therapy (CRT). This type of pacemaker is different from pacemakers used to treat other heart rhythm problems, such as bradycardia. This topic is only about pacemakers for heart failure. You might hear it only called cardiac resynchronization therapy, or CRT. When you have heart failure, the lower chambers of your heart (the ventricles) aren't able to pump as much blood as your body needs. Sometimes, the ventricles also don't pump at the same time. Cardiac resynchronization therapy (CRT) uses a special type of pacemaker called a biventricular pacemaker (say "by-ven-TRICK-yuh-ler") to treat heart failure. This pacemaker sends electrical pulses to make the ventricles pump at the same time. This can help the heart pump blood better. The pacemaker connects to three thin wires, called leads. The leads go into different chambers of your heart. If there is a problem with your heartbeat, the pacemaker sends a painless signal through the leads to fix the problem. The pacemaker also can speed up your heart if it is beating too slowly. In some cases, you may get a pacemaker for heart failure that is combined with a device to shock your heartbeat back to a normal rhythm if it is dangerously fast. The device is called an implantable cardioverter-defibrillator, or ICD. It can prevent sudden death. Your doctor will put the pacemaker in your chest during minor surgery. You will not have open-chest surgery. You probably will have local anesthesia. This means that you will be awake but feel no pain. You also will likely have medicine to make you feel relaxed and sleepy. Your doctor makes a small cut (incision) in your upper chest. In some cases, the pacemaker can be placed lower in the chest. This would allow you to wear clothing with a lower neckline and still keep the scar covered. The doctor puts the leads in a vein and threads them to the heart. Your doctor connects the leads to the pacemaker. Your doctor puts the pacemaker in your chest and closes the incision. Your doctor also programs the pacemaker. It can take about 2 to 3 hours to place the pacemaker. Most people spend the night in the hospital, just to make sure that the device is working and that there are no problems from the surgery. But sometimes the procedure is done as an outpatient procedure, which means you don't need to stay overnight in the hospital. You may be able to see a little bump under the skin where the pacemaker is placed. Whether a pacemaker for heart failure is right for you depends on many medical facts. Your doctor will check many things including:footnote 2 A pacemaker can help your heart pump blood better. It may help you feel better so you can be more active. It also may help keep you out of the hospital and help you live longer. A pacemaker can slow the progression of heart failure. It can do this by helping the heart's electrical system work well and by changing the shape of your heart. In heart failure, the left ventricle often gets too big as it tries to make up for not pumping well. The pacemaker can slow down this change in your ventricle. It might even help your ventricle go back to a more normal size. There are several risks to getting a pacemaker. But risks vary for each person. Your doctor can help you understand your risks. You will see your doctor regularly to check your pacemaker and make sure you don't have any problems. During and soon after the procedure. Problems can happen during or soon after the procedure to implant a pacemaker. Examples of problems include the following: After the procedure. Problems can also happen months or years after the pacemaker is implanted. These problems are related to the device or the leads. Most people do not have long-term issues with their pacemakers. Problems include: Daily precautions. You'll need to take steps to safely use electric devices. Some electric devices have a strong electromagnetic field. This field can keep your pacemaker from working right for a short time. Check with your doctor about what you need to avoid and what you need to keep a short distance away from your pacemaker. Many household and office electronics do not affect your pacemaker. Compare What is usually involved? What are the benefits? What are the risks and side effects? The risks from surgery are usually low. But they may be different for each person. Here are some possible risks:Problems can happen during the procedure to place the pacemaker or soon after the procedure. One example is a lung collapsing. These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I have a hard time getting my chores done around the house or going grocery shopping. I get really short of breath after walking for a few minutes. My doctor says a pacemaker could help me feel better. Jack, age 66 I had a heart attack a while ago, and now I have heart failure. My doctor says that a pacemaker might help me in the long run. But I don't really have symptoms. I can still work and take my daily walks with no problem. I'm more worried about having the device in my body. So I don't want it right now. Serena, age 55 My girlfriends and I go on a big trip every year. We visit museums and take long walks. I want to keep doing these trips for a long time. So I'm getting the pacemaker. I want to do everything I can so that my heart failure doesn't get worse anytime soon. Patty, age 72 My heart failure is getting a little worse. I can't play a whole round of golf anymore. My doctor and I talked about a pacemaker. But I'm scared of having one of those. I don't like the idea of wires in my heart. I told my doctor that I want to keep taking my medicine and follow my diet to see if that helps. If my heart failure gets worse, I'll look again at getting a pacemaker. Ralph, age 64 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to get a pacemaker Reasons not to get a pacemaker I want to do everything I can to slow down this disease. I'm afraid of having problems with the device later on. I have a lot of symptoms from heart failure. I want to feel better and be able to do more. I feel pretty good, and I'm not having too much trouble doing my daily activities. I don't mind having a device in my chest. I don't like the idea of having a device in my chest. I'm not worried about risks from surgery. I don't want to take a chance that something could go wrong during surgery. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Getting a pacemaker NOT getting a pacemaker Check the facts Decide what's next Certainty 1. How sure do you feel right now about your decision? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. A pacemaker for heart failure is used for cardiac resynchronization therapy (CRT). This type of pacemaker is different from pacemakers used to treat other heart rhythm problems, such as bradycardia. This topic is only about pacemakers for heart failure. You might hear it only called cardiac resynchronization therapy, or CRT. When you have heart failure, the lower chambers of your heart (the ventricles) aren't able to pump as much blood as your body needs. Sometimes, the ventricles also don't pump at the same time. Cardiac resynchronization therapy (CRT) uses a special type of pacemaker called a biventricular pacemaker (say "by-ven-TRICK-yuh-ler") to treat heart failure. This pacemaker sends electrical pulses to make the ventricles pump at the same time. This can help the heart pump blood better. The pacemaker connects to three thin wires, called leads. The leads go into different chambers of your heart. If there is a problem with your heartbeat, the pacemaker sends a painless signal through the leads to fix the problem. The pacemaker also can speed up your heart if it is beating too slowly. In some cases, you may get a pacemaker for heart failure that is combined with a device to shock your heartbeat back to a normal rhythm if it is dangerously fast. The device is called an implantable cardioverter-defibrillator, or ICD. It can prevent sudden death. Your doctor will put the pacemaker in your chest during minor surgery. You will not have open-chest surgery. You probably will have local anesthesia. This means that you will be awake but feel no pain. You also will likely have medicine to make you feel relaxed and sleepy. Your doctor makes a small cut (incision) in your upper chest. In some cases, the pacemaker can be placed lower in the chest. This would allow you to wear clothing with a lower neckline and still keep the scar covered. The doctor puts the leads in a vein and threads them to the heart. Your doctor connects the leads to the pacemaker. Your doctor puts the pacemaker in your chest and closes the incision. Your doctor also programs the pacemaker. It can take about 2 to 3 hours to place the pacemaker. Most people spend the night in the hospital, just to make sure that the device is working and that there are no problems from the surgery. But sometimes the procedure is done as an outpatient procedure, which means you don't need to stay overnight in the hospital. You may be able to see a little bump under the skin where the pacemaker is placed. Whether a pacemaker for heart failure is right for you depends on many medical facts. Your doctor will check many things including:2 A pacemaker can help your heart pump blood better. It may help you feel better so you can be more active. It also may help keep you out of the hospital and help you live longer. A pacemaker can slow the progression of heart failure. It can do this by helping the heart's electrical system work well and by changing the shape of your heart. In heart failure, the left ventricle often gets too big as it tries to make up for not pumping well. The pacemaker can slow down this change in your ventricle. It might even help your ventricle go back to a more normal size. There are several risks to getting a pacemaker. But risks vary for each person. Your doctor can help you understand your risks. You will see your doctor regularly to check your pacemaker and make sure you don't have any problems. During and soon after the procedure. Problems can happen during or soon after the procedure to implant a pacemaker. Examples of problems include the following: After the procedure. Problems can also happen months or years after the pacemaker is implanted. These problems are related to the device or the leads. Most people do not have long-term issues with their pacemakers. Problems include: Daily precautions. You'll need to take steps to safely use electric devices. Some electric devices have a strong electromagnetic field. This field can keep your pacemaker from working right for a short time. Check with your doctor about what you need to avoid and what you need to keep a short distance away from your pacemaker. Many household and office electronics do not affect your pacemaker. The risks from surgery are usually low. But they may be different for each person. Here are some possible risks:Problems can happen during the procedure to place the pacemaker or soon after the procedure. One example is a lung collapsing. These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. "I have a hard time getting my chores done around the house or going grocery shopping. I get really short of breath after walking for a few minutes. My doctor says a pacemaker could help me feel better." — Jack, age 66 "I had a heart attack a while ago, and now I have heart failure. My doctor says that a pacemaker might help me in the long run. But I don't really have symptoms. I can still work and take my daily walks with no problem. I'm more worried about having the device in my body. So I don't want it right now." — Serena, age 55 "My girlfriends and I go on a big trip every year. We visit museums and take long walks. I want to keep doing these trips for a long time. So I'm getting the pacemaker. I want to do everything I can so that my heart failure doesn't get worse anytime soon." — Patty, age 72 "My heart failure is getting a little worse. I can't play a whole round of golf anymore. My doctor and I talked about a pacemaker. But I'm scared of having one of those. I don't like the idea of wires in my heart. I told my doctor that I want to keep taking my medicine and follow my diet to see if that helps. If my heart failure gets worse, I'll look again at getting a pacemaker." — Ralph, age 64 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to get a pacemaker Reasons not to get a pacemaker I want to do everything I can to slow down this disease. I'm afraid of having problems with the device later on. I have a lot of symptoms from heart failure. I want to feel better and be able to do more. I feel pretty good, and I'm not having too much trouble doing my daily activities. I don't mind having a device in my chest. I don't like the idea of having a device in my chest. I'm not worried about risks from surgery. I don't want to take a chance that something could go wrong during surgery. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Getting a pacemaker NOT getting a pacemaker 1.
I don't need a pacemaker if I have mild heart failure and can still do my daily activities. 2.
A pacemaker could help me stay out of the hospital and live longer. 3.
If I get a pacemaker, I still need to take medicines for heart failure and follow a healthy lifestyle. 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? 1.
How sure do you feel right now about your decision? 2.
Check what you need to do before you make this decision. Current as of: June 24, 2023 Author: Healthwise Staff Clinical Review BoardHeart Failure: Should I Get a Pacemaker (Cardiac Resynchronization Therapy)?
Heart Failure: Should I Get a Pacemaker (Cardiac Resynchronization Therapy)?
1
Facts2
Options3
Feelings4
Decision5
Yourself6
Get the facts
Your options
Key points to remember
How does the pacemaker work?
How is the pacemaker placed?
Who can have a pacemaker for heart failure?
What are the benefits of having a pacemaker for heart failure?
What are the risks of having a pacemaker for heart failure?
Compare your options
Personal stories about getting a pacemaker for heart failure
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?
Your Summary
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
Author Healthwise Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.Heart Failure: Should I Get a Pacemaker (Cardiac Resynchronization Therapy)?
1. Get the Facts
Your options
Key points to remember
How does the pacemaker work?
How is the pacemaker placed?
Who can have a pacemaker for heart failure?
What are the benefits of having a pacemaker for heart failure?
What are the risks of having a pacemaker for heart failure?
2. Compare your options
Get a pacemaker Don't get a pacemaker What is usually involved? What are the benefits? What are the risks and side effects? Personal stories
Personal stories about getting a pacemaker for heart failure
3. What matters most to you?
4. Where are you leaning now?
5. What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
By Healthwise Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
FAQs
Get a pacemaker Get a pacemaker
Don't get a pacemaker Don't get a pacemaker
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You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
FAQs
More important
Equally important
More important
More important
Equally important
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Leaning toward
Undecided
Leaning toward
That's right. A pacemaker might be right for you even if you have mild symptoms. The pacemaker may slow the progression of heart failure. Your doctor can help you know if a pacemaker might help you.
That's right. A pacemaker for heart failure can help you stay out of the hospital and live longer.
You're right. You still need to take your medicines for heart failure and follow a healthy lifestyle. This includes eating healthy foods that are low in salt and not smoking.
Not sure at all
Somewhat sure
Very sure
Credits
References
Citations