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Pacemakers and implantable defibrillators are medical devices that regulate and support the heart’s rhythm. Pacemakers are often utilised to treat slow heart rhythms, sending electrical impulses to the heart to maintain a steady heartbeat. On the other hand, implantable defibrillators monitor and deliver corrective shocks to the heart in the presence of life-threatening arrhythmias (abnormal heart rhythms), enhancing overall cardiac function and preventing sudden cardiac arrest.
What Is a Pacemaker and Implantable Defibrillator?
A pacemaker is a small, implantable device designed to regulate and control the heart’s rhythm by emitting electrical impulses. It consists of a pulse generator and leads threaded into the heart. Pacemakers are commonly used to treat bradycardia, a condition characterised by a slow heart rate, ensuring that the heart beats in a stable rhythm.
An implantable defibrillator, also known as an implantable cardioverter-defibrillator (ICD), is a device implanted under the skin with leads in the heart to monitor your heart rhythm and deliver electrical shocks when it detects life-threatening arrhythmias. It combines pacemaker functions with the ability to provide defibrillation shocks, restoring a normal heart rhythm.
Who Needs a Pacemaker?
Pacemakers are recommended for individuals with bradycardia, a condition where the heart beats too slowly, causing symptoms such as fatigue, dizziness, or fainting. Those with atrial fibrillation or atrial flutter may also benefit from a pacemaker to coordinate the timing of the heart’s chambers and improve overall heart function.
Who Needs an Implantable Defibrillator?
Implantable defibrillators are typically recommended for individuals at risk of life-threatening ventricular arrhythmias, often due to a history of cardiac arrest, ventricular tachycardia, or certain types of heart disease such as heart failure. Individuals with a high risk of sudden cardiac death may be candidates for an implantable defibrillator to provide immediate intervention in the event of a dangerous heart rhythm.
What Happens During Pacemaker or Defibrillator Implantation?
The procedure is performed in an operating room or cardiac catheterisation laboratory. A small tube (cannula) is inserted into the vein in the arm for administration of contrast and medication. During device implantation, the patient is usually awake but sedated. A local anaesthetic is injected into the skin. When the skin is numb, a small incision is made near the collarbone, and leads (thin, insulated wires) are guided through veins that run under the collar bone into the heart. A pocket is then created under the skin and the device pulse generator is implanted typically in the left upper chest wall. Once in place, the leads are connected to the pulse generator, and the device is tested to ensure proper functioning.
What To Do After Pacemaker or Defibrillator Implantation?
After device implantation, patients are monitored in the hospital overnight. During your stay in hospital you will undergo a chest X-ray to check lead positions and for any potential complications, and will undergo a device check before discharge from hospital. Typically, patients can resume normal activities within a day or two. There may be some restrictions on arm movement on the side of the implantation site for the first few weeks. Regular follow-up appointments will be scheduled to check the pacemaker’s function, and patients will receive guidance on managing and maintaining their devices.
What are the Risks of Undergoing Pacemaker and Debrillator Implantation?
While device implantation is generally considered safe, potential risks include infection at the implantation site, bleeding or bruising, and damage to blood vessels or nerves near the implantation site. During the procedure, there is also a slight risk of pneumothorax (collapsed lung). Complications such as lead displacement or device malfunction may occur in rare cases.
