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Antwerp Hospital Network - ZNA

Cardiology

Pacemakers and ICD's (including cardiac resynchronisation therapy)

Implantation of pacemakers and defibrillators (ICD) are common practice in our centre. By implanting more than 300 devices per year, we are in Belgium a leading centre in the cardiac rhythm management of cardiac patients. Besides the classical indications, such as severe conduction disturbances, ventricular arrhythmias and sudden cardiac death, we have a broad experience in the research, evaluation and development of device implantation in like prevention of atrial fibrillation, prophylactic use for sudden death, heart failure. Cardiac resynchronisation therapy (CRT) by biventricular pacing is one of the new implantation techniques where we developed a large experience.

The incidence of heart failure, whatever its cause, is exponentially growing and the exploding population with heart failure will be a major health problem to deal with in the near future. Although optical medical treatment, especially conducted by a Heart Failure Clinic, can be achieved in a large portion of the population, high numbers of patients become intolerant and/or refractory for this medical treatment. In some of them the so called "left ventricular asynchrony" is present and accounts for at least a part of this refractoriness. This asynchrony, evaluated by non-invasive electrocardiography and echocardiography, can be relieved by biventricular pacing, which sort of resynchronise both ventricular heart chambers.

Our centre has more than 10 years of experience in implanting CRT-D (defibrillator) and CRT-P (pacemaker) devices. Over the years, with our experience in interventional cardiology, we adjusted and fine tuned the implantation technique in order to achieve a successful positioning of the left ventricular lead within 90 minutes in 90% of the cases. Only in less than 5% surgical (minimal invasive) positioning is needed. At present the implantation of a CRT device does not take much more time than a conventional device implantation. Compared to standard pacemaker and ICD implantations, no significant difference regarding patient's discomfort and rehabilitation is present.

CRT implantation requires not more than 2 days of hospitalisation. Further adjustments through reprogramming of the device are conducted in cooperation with our Heart Failure Clinic.