Different devices, different roles
Implantable cardiac devices are used for selected heart rhythm problems and some forms of heart failure. The type of device recommended depends on the problem being treated; a pacemaker, an implantable defibrillator and a CRT device do not all serve the same purpose.
A device system usually includes a generator containing a battery and electronic circuitry. Many systems also use insulated wires called leads to sense electrical activity and deliver treatment.
Pacemakers
A pacemaker sends small electrical pulses to help maintain an appropriate heart rate. It is commonly used when the heart beats too slowly or its electrical conduction is impaired.
The device can sense the heart’s own electrical activity and provide pacing when needed. Suitability depends on an assessment of the rhythm problem and its effect on the patient.
Implantable defibrillators: ICD or AICD
An implantable cardioverter-defibrillator monitors the heart for certain dangerous fast rhythms. It may deliver pacing or an electrical shock to treat a detected rhythm, depending on the device and its programming.
Some ICDs also provide pacemaker functions. Your cardiologist will explain why a defibrillator may be considered, the type of treatment it can deliver and what living with the device involves.
Cardiac resynchronisation therapy
Cardiac resynchronisation therapy, or CRT, is an option for selected people with heart failure whose lower heart chambers do not contract in a coordinated way.
A CRT device delivers electrical impulses to help the ventricles work together more effectively. Depending on the patient’s needs, a system may also include defibrillator capability, known as CRT-D.
Implantation and regular follow-up
Implantation and recovery are planned around the patient and the device. Ask about the expected hospital stay, wound care, activity restrictions and the possible risks of the procedure.
Regular checks allow the care team to review the battery, leads, stored rhythm information and device settings. Some follow-up may be performed remotely when the device and care plan allow it.
Discuss how to recognise a device-related problem and what to do if a shock occurs. Device implantation carries risks, including bleeding and infection, which should be reviewed before treatment.
YOUR QUESTIONS
A little more clarity.
Are a pacemaker and an ICD the same?
No. A pacemaker mainly supports a slow heartbeat. An ICD is designed to detect and treat certain dangerous fast rhythms; some ICDs also provide pacing.
Does everyone with heart failure need CRT?
No. CRT is suitable for selected patients after assessment of their heart function, electrical activity and other clinical factors.
Will the device need checking?
Yes. Device follow-up is part of continuing care. Your team will explain the schedule and whether remote checks are available.