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Other Therapy

A rapidly growing newer therapy is called cardiac resynchronization therapy and involves a biventricular pacemaker.

• One pacer is placed in a coronary vein on the back side of the heart, overlying the left ventricle. The other pacer is placed in the usual right ventricle position. This improves the coordination of contraction between the left and right ventricle, especially if the patient has left bundle branch block.
  
  
• Biventricular pacing has been shown to improve exercise capacity, and, in a recent clinical trial, it has been found to prolong life.
  
  
• Cardiac resynchronization therapy is frequently combined with an ICD to shock a person out of life-threatening arrhythmias, such as ventricular tachycardia or ventricular fibrillation. The worse the left ventricle, the higher the risk for sudden death secondary to these arrhythmias.
  
  
• Whether biventricular pacing will work so well as to prevent deterioration of the left ventricle and the need for heart transplantation is unknown.