Pacemaker Implantation

Your physician has determined you need a pacemaker. You may have a slow or irregular heart rate, or your heart rate may be normal at times and too fast or too slow at other times. A pacemaker can help your heart beat more regularly.

An artificial pacemaker system is made up of two parts, a generator and leads. The generator is a small battery-powered unit that produces electrical impulses that are transmitted down the leads which are tiny wires that carry the impulses to the heart.

Patients are usually given a mild sedative prior to the procedure. This will help you feel more relaxed and may be a bit sleepy. You will be taken to a sterile room with special cameras for the procedure. After the skin has been cleansed, a small incision will be made in your chest just below your collarbone. A pocket is made under the skin for the generator to sit in. The lead is then threaded into the vein under the collarbone and placed, with the help of x-ray monitors, into your heart. Next, the generator is programmed to treat your specific rhythm problem, and the leads are attached to the generator. The generator is then placed into the pocket, and the incision is closed with stitches.

After your pacemaker implant you will stay in the hospital overnight. It is normal for the incision to be a bit tender and bruised. You will be given specific instructions regarding care of the incision site. If you notice redness, drainage, severe pain, or swelling, talk to your doctor to see if further evaluation is indicated.

Prior to the procedure, you will be told not to eat or drink anything after a certain time. Your doctor will inform you which of your medications you should take prior to the procedure, and which medications to avoid before your pacemaker implantation. Please inform your doctor if you have any allergies. If indicated, he or she will prescribe any medications needed to reduce the risk of an allergic reaction. 

NextGen Patient Education Material

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What is an Implantable Cardioverter Defibrillator (ICD)?


An ICD is a battery-powered device placed under the skin that keeps track of your heart rate. Thin wires connect the ICD to your heart. If an abnormal heart rhythm is detected the device will deliver an electric shock to restore a normal heartbeat to stop your heart is beating chaotically and much too fast.

ICDs have been very useful in preventing sudden death in patients with known, sustained ventricular tachycardia or fibrillation. Studies have shown that they may have a role in preventing cardiac arrest in high-risk patients who haven't had, but are at risk for, life-threatening ventricular arrhythmias.

 

Why do I need an ICD?


Your doctor may recommend an ICD if you are at risk of a life-threatening ventricular arrhythmia because of having:

  1. Had a ventricular arrhythmia
  2. Had a heart attack
  3. Survived a sudden cardiac arrest
  4. Long QT syndrome
  5. Brugada syndrome
  6. A congenital heart disease or other underlying conditions for sudden cardiac arrest

 

How is an ICD implanted?


A battery-powered pulse generator is implanted in a pouch under the skin of the chest or abdomen, often just below the collarbone. The generator is about the size of a pocket watch. Wires or leads run from the pulse generator to positions on the surface of or inside the heart and can be installed through blood vessels, eliminating the need for open-chest surgery.

 

How does an ICD work?


It knows when the heartbeat is not normal and tries to return the heart beat to normal.

  1. If your ICD has a pacemaker feature when your heartbeat is too slow, it works as a pacemaker and sends tiny electric signals to your heart.
  2. When your heartbeat is too fast or chaotic, it gives defibrillation shocks to stop the abnormal rhythm.
  3. It works 24 hours a day.

New devices also provide “overdrive” pacing to electrically convert a sustained ventricular tachycardia (fast heart rhythm) and "backup" pacing if bradycardia (slow heart rhythm) occurs. They also offer a host of other sophisticated functions such as storage of detected arrhythmic events and the ability to perform electrophysiological testing. Stored information can help your doctor optimize the ICD for your needs. 

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