How pacemakers and implantable defibrillators are implanted and used

The heart is a four-chambered pump with its own electrical system. When the electrical system is faulty or in need of repair, a cardiac device, such as a pacemaker or defibrillator, is implanted. A pacemaker keeps the heart from beating too slowly. When the heart's own electrical system misses a signal to stimulate the heart to beat, a pacemaker sends the signal to replace it.

A defibrillator, or ICD, corrects fast heart rhythms from the ventricles, or lower chambers of the heart.

Most defibrillators have built-in pacemakers. A biventricular system is a pacemaker or defibrillator with two leads in the lower chambers or ventricles. This system helps the heart beat more efficiently and is often used to treat a condition called heart failure.

Cardiac devices are small, lightweight, electronic devices that hold a battery and tiny computers. Typically, they are placed under the skin, just below the collarbone.

Insulated wires, or leads, are threaded through large veins, ending up in the heart. The leads are attached to the cardiac device. The batteries last an average of five to seven years depending on their use. Some last more than that, some last less. When a battery change is indicated, the entire device is replaced, but the leads or wires are often reused.

Pacemakers, defibrillators and heart monitoring devices are implanted in people of all ages. In most cases, individuals can lead a normal life with minimal restrictions.

Strenuous exercise or sexual activity may be resumed once your physician clears you to do so. Common items that you may come in contact with such as microwaves, computers and metal detectors will not interfere with the device's function. There are a few precautions.

Cell phones need to stay 10 inches away from the implanted device due to potential interference. Close contact with running engines, generators or welders should be avoided. Most medical procedures will not interfere with your implanted device, including X-rays, CAT scans, ultrasounds and mammograms. Contact the office managing your device to see if you have an MRI safe device. What you will need to be aware of will be discussed in more detail in the patient education booklet you will receive in your teaching folder.

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