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Pacemakers and Other Implantable Cardiac Devices

What is an arrhythmia?  Your heart beats because of a signal that tells the chambers of the heart to squeeze and pump blood throughout your body. The rhythm of the beats is controlled by an electrical signal.  Sometimes aging or disease cause this signal to be interrupted and the rhythm can slow down or become irregular.  This abnormal rhythm is called an arrhythmia.

 

What is a pacemaker?  Irregular heartbeats sometimes cause symptoms of dizziness, shortness of breath, or fainting. A pacemaker is a small device that is placed under the skin of your chest or abdomen to help control abnormal heart rhythms.  This medical device uses electrical impulses to contract the heart muscles and to regulate the heartbeat.  The purpose of a pacemaker is to keep your heart beating at a normal rate. From outside of your body, through the skin or even your clothes, the doctor can adjust the pacemaker using a small device known as a “programmer.”  This device allows the doctor to quickly and easily change the pacemaker settings based upon your individual needs.

 

To decide whether a pacemaker will benefit you, your doctor will consider any symptoms you may have, and if you have a history of heart disease, what medicines you are currently taking, and the results of special tests.  If a pacemaker is appropriate for you, your doctor will decide on which type of pacemaker to implant.  There are several different types of pacemakers depending on your specific condition:  single chamber, dual chamber, and biventricular pacemakers.  A biventricular pacemaker is often used in a patient who has congestive heart failure or a weakened heart, and an irregular heartbeat.  These devices are also called CRT, for cardiac resynchronization therapy, and help to coordinate the pumping activity of your heart.

 

The pacemaker is about the size of an OreoTM cookie.  The doctor puts it into your body by making a small cut or incision in the upper left or right side of your chest.  Special pacing wires, or electrodes, will be passed through a vein in your chest to the right side of your heart.  After the electrodes are placed, your doctor will place the pacemaker in a “pocket” created beneath your skin, and attach the electrodes to the pacemaker. Once the pacemaker is secure, the incision will be closed and bandaged.  The procedure takes between two and four hours.

 

What is a defibrillator?  Some devices combine a pacemaker and defibrillator into one.  Sometimes the heart beats in a very irregular way, either too fast or with an irregular rhythm that does not allow your heart to pump blood to the rest of your body.  These types of arrhythmias can lead to cardiac arrest, when the heart suddenly and unexpectedly stops beating.  A defibrillator is an implantable cardiac device (ICD) that shocks the heart back into a normal rhythm.  Because it has a pacemaker built into it, a defibrillator also has the ability to stimulate the heart like a pacemaker, to help stop fast rhythms and to prevent the heart from beating too slowly.  

 

Highlights

Last year, BMC implanted 232 pacemakers and 224 other implantable cardiac devices (ICD).  BMC participates in the American College of Cardiology National Cardiac Data Registry (ACC NDCR) for Implantable Cardiac Devices, and for the past 5 years, our adverse events have been lower than the national benchmarks (ACC NDCR). 

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