Stanford Cardiac Arrhythmia Service

Implanting the BPID

The procedure to implant the Biventricular Pacing Implantable Defibrillator is performed in the cardiac catheterization laboratory.
Your upper chest will be scrubbed and shaved (if needed) and you’ll be covered with sterile sheets. You’ll receive medication through an IV to help you relax. We’ll also apply a local anesthetic at the site of implantation. 

After the area is numb, your physician will access the heart through the vein under the collar bone. Wires or leads will be inserted into this vein and advanced to your heart’s chambers using fluoroscopy (x-ray monitors).

The lead that will pace the left ventricle is advanced into the vein on the outside of the left ventricle. In about 10% of cases, it’s not possible to place the wire or lead into that vein because the branches of the veins are too small. In about 5 to 10% of cases, the wire or lead may need to be repositioned because it has moved or paces the diaphragm, causing the chest to twitch. 

Once the wires are in position, your physician will make a two- to three-inch incision in your skin to create a small “pocket.” The wires or leads will be connected to the BPID, which is placed into the pocket. Finally, the incision will be stitched up.

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