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Therefore, to be eligible for the biventricular pacemaker, heart failure patients must: Have severe or moderately severe heart failure symptoms Be taking medications to treat heart failure Have the LV/RV synchrony problems mentioned above (your doctor can usually determine this using ECG testing) In addition, the heart failure patient may or may not need this type of pacemaker to treat slow heart rhythms and may or may not need an internal defibrillator (implantable cardioverter defibrillator, or ICD), which is designed to treat people at risk for sudden cardiac death or cardiac arrests