If you are one of the 175,000 people who yearly have a pacemaker implanted, this news is both important and sobering. A new study shows pacemakers can actually cause heart failure.

In the study, the researchers evaluated the pacemakers of more than 23,000 patients. Most pacemakers in use today stimulate only the right side of your heart. The pacemaker might stimulate only your right ventricle or both your right atrium and right ventricle. The electrical impulse then spreads to the left side.

Here's the problem. In a normal heart, both upper chambers (atriums) are stimulated first. Then the impulse travels to your ventricles, stimulating your left ventricle before the right. Your left ventricle is your main pumping chamber. That's where heart failure usually starts.

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The out of sync beating puts extra stress on the left ventricle
leading to congestive heart failure. When the heart fails, it causes
blood to back up into your lungs and you get fluid overloaded. It's a real nightmare.

Patients with a pacemaker that stimulated both the right chambers
had a 36% higher risk of hospitalization or death from heart failure
than a control group of people in similar health, but without a
pacemaker. If the pacemaker stimulated only one right chamber, there was a 59% higher risk. These are huge numbers and cause for great concern.

Cardiac device expert Dr. Michael Sweeney at Boston's Brigham and Women's Hospital said, "The way we practiced cardiac pacing for the last three decades must be abandoned." I agree completely. But don't think that I'm against all pacemakers. If your heart's natural pacemaker malfunctions, your heart can stop beating long enough for you to lose consciousness or even suffer sudden death. So I recommend them regularly. But not just any pacemaker.

There's a new pacemaker that stimulates both lower heart chambers to contract in sync. These already appear to limit congestion in early studies.

Dr. Sweeney is conducting such a study now. However, the drawback is that these more sophisticated pacemakers cost about $10,000 more for just the device, not including hospital and surgeon fees. This might seem like a lot, but a case of heart failure will cost many more times that. If you need a pacemaker, please ask your surgeon about the double stimulation device. Your heart will thank you.

Usually orthodox heart failure management is maintenance. I prefer to prevent. Before you have heart problems, it's time to take steps to protect your heart. You can find many articles on my website with specific steps you can take to do just that. Subscribers to my monthly newsletter, Second Opinion, can access all the back issues free of charge. All you have to do is login using the user name and password that are in each issue. If you're not a subscriber, you can find out how to subscribe at www.secondopinionnewsletter.com.

Ref: "Study: Pacemakers Can Cause Heart Failure," Am J Cardiology, March 2005.


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