Electrophysiology: Pacemakers, ICDs, and Ablation Fact Sheet

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Pacemakers and implantable cardioverter defibrillators (ICDs) are small devices that can be implanted in the body to send electrical impulses to the heart muscle to maintain a suitable heart rate and rhythm. They are implanted during a minor surgical procedure.

What is a pacemaker?

• A pacemaker is a small device, about the size of a wristwatch, that helps regulate your heart rate.
• A pacemaker is made up of leads (thin flexible wires) and a generator (battery).Pacemakers send an electric impulse to the heart when the rate drops below a certain level. Your doctor will determine this level.
• There are several different types of pacemakers, but they all normally treat slow heart rate. Most work only when they are needed (demand pacemakers), other pacemakers work all the time. Your doctor will decide which pacemaker is right for you.

Why do I need a pacemaker?

• Bradycardia – when your heart beats consistency too slow
• Cardiomyopathy – the heart becomes swollen and cannot function properly
• Dizziness, severe fatigue (tiredness), fainting (passing out) or confusion

What is an ICD?

• An ICD is a small device made up of leads and an generator that connect to your body. The lead
connects the ICD to the inside of your heart. The generator contains a battery operated computer that monitors your heart rate and rhythm.
• Some arrhythmias can cause the heart to beat too fast. The ICD will give your heart a jolt (shock) to start your heart beating normally again. An ICD can make your heartbeat faster if it is not beating fast enough and it can slow your heart down if it is beating too fast.

Why do I need an ICD?

• Certain conditions where your heart muscle is weakened. These include a heart attack, congestive heart failure (CHF) or coronary artery disease (CAD)
• Slow heart rate
• Ventricular fibrillation – an arrhythmia where your heart beats irregularly and your heart cannot function anymore
• Ventricular tachycardia – an arrhythmia when your heart beats too fast, it may cause dizziness, fainting (passing out), and sudden death

How do I get a pacemaker or an ICD?

• You will need a small surgical procedure to get a pacemaker or ICD. The procedure will take about one to two hours. Your doctor will decide if you will have the procedure done as an inpatient or an outpatient.
• You may be completely asleep during the procedure. In most cases, you will be awake, but very drowsy.
• Your doctor will give you medicine to help you relax. An incision will be made in your neck or chest. With the help of a special X-ray, the leads of the pacemaker or ICD will be guided into your heart.
• The leads are connected to the pacemaker or ICD generator and are programmed especially for the needs of your heart. Most ICD’s are placed in a pocket under the skin in the shoulder area.
• An X-ray will be taken after surgery to make sure the ICD is in the right position.

What does it feel like?

You will not feel the pacemaker monitoring your heart. You will be able to see and feel the outline of the device through your skin. When the ICD notices an abnormal heart rhythm and gives your heart a shock, it may feel like someone has hit you or you may feel a thump in the chest. If someone is touching you when you get a shock, they will feel a small tingling feeling.

Other electrophysiology procedures

Cardiac ablations are performed to fix a “short circuit” in the heart. The short circuit may cause a “circus rhythm”. Your doctor performs a cardiac ablation to destroy the faulty circuit and return the heart to normal function.

Cardiac ablations are performed through a catheterization. Long thin catheters are threaded through a blood vessel, usually in the leg and up into the heart. Electrodes at the tip of the wires help the doctor see the exact location of the faulty tissue. Three dimensional maps of the electrical circuits in the heart can also be constructed. The doctor then uses a specialized catheter wire that is made either extremely hot or cold to destroy the tissue.

Resources

UK HealthCare Gill Heart Institute
1-800-333-8874
www.ukhealthcare.uky.edu

American Heart Association
1-800- AHA-USA-1 (242-8721)
www.americanheart.org

National Heart, Lung, and Blood Institute
301-592-8573
www.nhlbi.org

To make an appointment or find a physician, please call UK HealthCare at 859-257-1000 or toll free 1-800-333-8874.
Copyright © 2007, University of Kentucky, 800 Rose St., Lexington, Kentucky, USA 40536.

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Page last updated Wednesday, February 28, 2007 10:52 AM