Pacemaker for heart failure

When you have heart failure, the lower chambers of your heart (the ventricles) aren't able to pump as much blood as your body needs. Sometimes the heart has a problem with the electrical system that controls the pumping. This means the ventricles don't pump at the right time or the heart has an abnormal rhythm. A pacemaker for heart failure can help the heart pump blood better.

A pacemaker for heart failure is a device that sends electrical pulses to make the ventricles pump at the same time. This type of pacemaker can improve your symptoms of heart failure. It can help you feel better so you can be more active. It also can help keep you out of the hospital and help you live longer.1

Cardiac resynchronization therapy (CRT)

Using a pacemaker to make the ventricles pump at the same time is called cardiac resynchronization therapy, or CRT. This type of pacemaker is different from pacemakers used to treat other heart rhythm problems, such as atrial fibrillation.

Cardiac resynchronization therapy may be used for people with severe heart failure (class III or class IV).2

Biventricular pacemaker

A pacemaker for heart failure is called a biventricular (say "by-ven-TRICK-yuh-ler") pacemaker, because it sends signals to both ventricles. The pacemaker is implanted in the chest, and it connects to three thin wires, called leads. The leads go into different chambers of your heart. If there is a problem with your heartbeat, the pacemaker sends a painless signal through the leads to fix the problem. The pacemaker also can speed up your heart if it is beating too slowly.

In some cases, a person who has heart failure may get a pacemaker that is combined with a device that can shock the heart back to a normal rhythm if it is beating dangerously fast. The device is called an implantable cardioverter-defibrillator (ICD). It can prevent sudden death from certain types of abnormal heartbeats (life-threatening arrhythmias).

For more information and help deciding whether to get a pacemaker, see:

Click here to view a Decision Point. Should I get a pacemaker for heart failure?


  1. McKelvie R (2008). Heart failure, search date January 2007. Online version of BMJ Clinical Evidence. Also available online:
  2. Epstein AE, et al. (2008). ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation, 117(21): e350–e408.

Last Updated: August 25, 2008

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