Implant of Biventricular Permanent Pacemaker (CRT P)

Implant of Biventricular Permanent Pacemaker (CRT P) Explanation of procedure The aim of the biventricular (both ventricles) permanent pacemaker is to treat your weak heart muscle by restoring supporting the heart's pumping co-ordination function. The procedure involves inserting wire(s) remove brackets as we know there will be more than one! (also called leads) into your heart through a vein just under your collar bone. This is done with the help of X-rays. An incision is made (usually just below the collar bone, near where the vein that the wires are inserted into) and a space is formed just below the skin to make a `pocket’. The wire(s) are then connected to the biventricular pacemaker battery box which is put into a pocket made under your skin in the same area. The pocket is then closed using surgical stitches.

The intended benefits of this procedure To treat symptoms associated with your weak heart muscle so that you can do more and feel better.

Serious or frequently occurring risks: Less than 1 in 100 risk of serious or life threatening complications such as blood clots which could cause a stroke or heart attack; puncture of the blood vessels or heart wall which could lead to a collection of blood in the sac surrounding the heart and which could require an emergency operation to repair. 2 in 100 risk of bleeding or bruising around the wound site which may require a tight bandage overnight to control, removal of blood clots from around the box or removal of the entire system. This risk is increased if you are taking blood thinners. 2 in 100 risk of infection in or around the wound. 0-5 in 100 risk of collapsed lung during the procedure. 10-15 in 100 risk of being unable to place the wire securely on the left side of the heart. This may require a further surgical operation at a later date. 5-10 in 100 risk of the wire(s) moving out of position requiring a further procedure to re- position the wire(s) at a later date. 30 in 100 patients may experience no improvement in their symptoms of heart failure

I have discussed what the procedure is likely to involve, the benefits and risks of any available alternative treatments (including no treatment) and any particular concerns of this patient.

Biventricular permanent pacemaker (CRT P) patient information leaflet and a wound care advice sheet has been given to you.

The procedure will involve: □ General anaesthesia □ Local anaesthesia □ Sedation

V3 Oct 2010