Why you might need this test

We may fit you with a biventricular pacemaker if you suffer from heart failure. Some of the common causes of heart failure include:

  • a previous heart attack

  • high blood pressure

  • heart valve disease

  • excessive alcohol consumption over a long period of time

  • damage to the heart muscle from a viral infection

  • an untreated heart muscle problem

You may also suffer from symptoms such as tiredness or a loss of energy, breathlessness and swollen ankles and feet.

Biventricular pacemaker device

We use this device to treat people with heart failure, as it helps the heart muscle pump blood and works better.

The biventricular pacemaker is a device that has a small metallic box, called a generator, with three leads attached to it. These leads are attached to the heart via veins. We place two leads in the right side of the heart and the remaining lead in the left side.

Once the device has been fitted, we can then stimulate or 'pace' your heart with a small electrical pulse. We then make sure that the left and right chambers are working together as they should.

If you are still experiencing symptoms of heart failure after the pacemaker has been fitted, we may do an optimisation procedure. This echo-guided procedure helps us to adjust the settings of your pacemaker to help your heart function better.

Optimising your pacemaker

This procedure will is done by a doctor or cardiac physiologist. We will ask you to remove any clothing from the waist up and then lie down on your back on to an echocardiogram bed. During the test, we may get you to roll onto your left side, but we will let you know. We will then place three electrodes to your chest which are connected to the echo machine.

We will then put the echo recorder onto your chest. This is a small hand-held transducer, which will have some lubricating jelly already on it. This might feel a little cold at first. We use this to take images of your heart from different positions on the chest.

The echo recorder sends high-frequency sound waves to your heart. It then records the echoes of the sound waves reflected back from your heart. The echoes are picked up by the echocardiography machine as electrical impulses and then converts them into moving images of your heart.

During the test, a pacing technician will test your pacemaker to check the rhythm and timing of your heart. They will assess your device by a set of echo measurements and check your heart's function at different settings.

Your device will then have the relevant adjustments made so that it is pumping more effectively.

This test should take between 45 minutes to an hour to complete.

For information on getting your results and contact the team, click on the 'Information' tab. 

There are currently no related conditions associated with this test.

Getting your results

Your doctor or cardiac physiologist will give you immediate feedback on your report at the end of the test. Your pacemaker will have the needed adjustments made to the best-identified settings.

Your results are sent to your cardiologist who will discuss the results with you. They will also organise a follow-up visit to reassess your heart condition.


Getting in touch

Royal Brompton Hospital

Level 3, Chelsea wing
Royal Brompton Hospital
SW3 6NP

Contact details

Monday to Friday 9am to 5pm
Tel: +44 (0)20 7351 8209
Fax: +44 (0)20 7351 8604

Harefield Hospital

Echocardiography clinic room,
Outpatients department,
Harefield Hospital,
UB9 6JH

Contact details

Monday to Friday 9am to 5pm
Tel: +44 (0)1895 823737 ext: 5586


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