Heart Failure: Should I Get a Pacemaker (Cardiac Resynchronization Therapy)?

Heart Disease

Decision Point

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.

Heart Failure: Should I Get a Pacemaker (Cardiac Resynchronization Therapy)?

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Get a pacemaker Don’t get a pacemaker
What is usually involved?
  • The doctor will numb the area so you won’t feel pain. (This is not open-chest surgery.)
  • It can take up to 2 to 3 hours to place the pacemaker.
  • You may spend the night in the hospital to make sure that the device is working and that there are no problems.
  • You will need regular checkups to make sure that the pacemaker is working and to adjust the pacing, if needed.
  • You still need to take medicines for heart failure.
  • You still have to eat healthy foods and exercise as your doctor advises. You also may need to limit salt and fluids.
  • You take medicines for heart failure. Your doctor may change the type or dose of your medicines.
  • You have to eat healthy foods and exercise as your doctor advises. You also may need to limit salt and fluids.
  • You may have to see your doctor often to check your symptoms and how your medicine is working.
What are the benefits?
  • A pacemaker can help you feel better so you can be more active.
  • It can help keep you out of the hospital and help you live longer.
  • It can help your heart pump better 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.
  • You won’t have the risk of infection or other problems from the surgery.
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:4

  • A lead could tear the heart.
  • A lung could collapse from a buildup of air in the space between the lung and the chest wall.
  • You could get an infection in the chest.
  • The doctor might not be able to place the pacemaker. For example, a vein could be too small to place a lead.

After surgery, you may have some other risks:

  • You will need surgery to replace the battery, which lasts 8 to 10 years.
  • If a lead breaks or the pacemaker stops working, you may need another surgery to fix the problem.
  • Some devices with strong magnetic or electrical fields could stop the pacemaker from working. You need to avoid MRI machines, battery-powered cordless power tools, and CB or ham radios. But most everyday appliances and electronic devices are safe.
  • Your symptoms could get worse. This would limit your ability to do your daily activities.
  • If your heart failure gets worse, you may have to go into the hospital a lot.
  • You might not live as long as you could if you had a pacemaker.2
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