In recent years, new technology has been developed for patients
with both advanced heart failure and mechanical “dyssynchrony.”
Dyssynchrony occurs when the right side of the heart beats out
of step with the left side of the heart as identified on
electrocardiogram (ECG) or echocardiogram. These devices consist
of a pacemaker or an ICD connected to three wires which are
placed in the right atrium, right ventricle, and coronary
sinus—a large vein behind the left ventricle (see diagram). By
pacing from three distinct locations “in synchrony” the weakened
heart can often beat more effectively resulting in improved
quality of life and length of life. The surgical techniques and
potential complications are similar to conventional pacemaker or
ICD insertions albeit higher due to the added complexity of
placing the special third wire on the left side of the heart.
Johns Hopkins has played an important role in the development of
resynchronization therapy for the treatment of heart failure
patients.