Pacemaker (single, Double And Biventricular)

Pacemaker implantation is a life-saving cardiac intervention performed by expert cardiac electrophysiologists at Moolchand Hospital, the best heart hospital in Delhi. A pacemaker is a small, battery-powered device that monitors the heart's electrical activity and delivers precisely timed electrical impulses through leads (insulated wires) placed in heart chambers to maintain an adequate heart rate when the heart's natural conduction system fails to do so reliably.

Single-chamber pacemakers have one lead placed in either the right atrium (AAI mode — for sinus node dysfunction with intact AV conduction) or right ventricle (VVI mode — for chronic atrial fibrillation with slow ventricular rates). Single-chamber ventricular pacemakers are the most commonly implanted and are used for high-degree AV block in patients with atrial fibrillation, providing reliable ventricular rate support.

Dual-chamber pacemakers (DDD) have two leads — one in the right atrium and one in the right ventricle — allowing the device to sense and pace both chambers in a coordinated, physiological sequence that mimics the normal atrial-triggered ventricular activation (AV synchrony). Dual-chamber pacing is indicated for sick sinus syndrome with intact AV conduction, AV block in sinus rhythm, neurocardiogenic syncope, and hypertrophic obstructive cardiomyopathy (HCM) requiring AV sequential pacing. DDD pacing significantly improves exercise capacity, prevents pacemaker syndrome (fatigue and presyncope from loss of AV synchrony), and may improve long-term outcomes compared to single-chamber pacing in selected patients.

Cardiac resynchronization therapy (CRT) — also called biventricular pacing — uses a three-lead system placing leads in the right atrium, right ventricle, and left ventricle (via the coronary sinus and its tributaries) to synchronize the contraction of both ventricles simultaneously. CRT is indicated for patients with symptomatic heart failure (NYHA class II–IV), reduced ejection fraction (≤35%), and electrical dyssynchrony shown by left bundle branch block (QRS duration ≥130ms) — conditions where the left and right ventricles contract out of synchrony, reducing cardiac efficiency. CRT significantly improves symptoms, exercise capacity, quality of life, and survival in appropriate heart failure patients. When combined with defibrillation capability (CRT-D), it additionally provides protection from sudden cardiac death.

Leadless pacemakers (intracardiac devices implanted directly into the right ventricle through the femoral vein without transvenous leads or a pacemaker pocket) are available for selected patients — particularly those with previous device infection, lack of venous access, or those at high infection risk.

At Moolchand Hospital in Lajpat Nagar Delhi, our cardiac electrophysiology team performs all types of pacemaker and CRT implantation in fully equipped catheterization laboratories, with comprehensive device programming, remote monitoring, and regular follow-up in our dedicated device clinic.