Implanted Medical Devices for Heart Disease

Heart disease can become life-threatening if symptoms persist after less invasive treatments such as medication, lifestyle changes, or minor surgery have been tried.
Implanted medical devices may be recommended when other treatments don’t work. The options may effectively correct some heart conditions on a long-term basis. They may also act as a transition to a more invasive treatment plan, such as a heart transplant.

The following information provides an overview of implanted medical devices. However, it is always best to talk with your doctor about the best treatment options for you.

Pacemaker

A pacemaker is perhaps the most well-known implanted medical device for heart patients. It is surgically inserted into the abdomen or chest cavity. They’re used when people are experiencing arrhythmia, or irregular heartbeat. This means that heart beating patterns are too fast, too slow, or uneven.
The first-line treatment for arrhythmia includes medications, a single electric shock (cardioversion), or a catheter procedure that destroys the abnormal tissue that contributes to an irregular beating pattern. Your doctor may suggest a pacemaker if these treatments have failed.

How It Works

A pacemaker is an internal monitoring system for your heart that measures:

• electrical activity
• beating pattern
• heart rate
• blood temperature

When your heart’s electrical system isn’t working properly, the battery-powered pacemaker returns your heart to a normal rhythm with an electrical impulse. The life span of a pacemaker generator and battery average seven years. After that time a replacement pacemaker may be necessary.

Procedure

Surgery to install a pacemaker is performed in a hospital setting under general anesthesia. Your surgeon places the small device and its battery pack under your skin. A wire will then be threaded through your veins and up to your heart. The procedure may take several hours, and then there is usually an overnight hospital stay.

Recovery time is brief. You may experience soreness at the incision for several days, but you can return to your daily regimen whenever you feel ready.
Risks of pacemaker implants may include:

• swelling or bruising at the incision site
• infection
• damage to blood vessels or nerves
• collapsed lung

Precautions

People who have pacemakers must be vigilant about potential interference from electronics such as cell phones, microwave ovens, and metal detectors. It’s important to put some distance between your pacemaker and these electrical devices.
For example, carry your cell phone in a back pocket or purse rather than in a shirt pocket, and don’t stand close to a microwave for extended periods of time.
Also, notify personnel at airports and other locations outfitted with metal detectors and other imaging equipment. The machinery may react with your pacemaker.

Ventricular Assist Device

A ventricular assist device is a temporary measure used to prevent end-stage heart failure. This device is also called a left ventricular assist device (LVAD) because it helps perform the job of the heart’s left ventricle.
The left ventricle is the largest chamber of the heart. It’s responsible for pumping blood from your heart to the rest of your body.

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People who are on the list for a heart transplant may require an LVAD to perform the job that their heart is too weak to do. This device is often referred to as a “bridge to transplant.” It is often used as a measure to save lives until a suitable donor heart is found.
Risks of the surgery include:

• infection
• device failure
• heart failure
• blood clots

Implanting an LVAD involves open-heart surgery and takes four to six hours to complete. You’ll be placed on a ventilator and heart-lung machine while the device is implanted in your chest cavity. Expect to spend a few days in the intensive care unit directly after surgery.
A stay in intensive care will allow your doctor to monitor the LVAD to ensure it is working correctly. Your doctor will also be able to adjust your levels of blood-thinning medicine.
Recovery depends on your overall health before the surgery. Some people are well enough to go home within a few days. Others may remain in the hospital until a donor heart is available.

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Implantable Cardioverter Defibrillator

An implantable cardioverter defibrillator (ICD) is similar to a pacemaker. Both devices are used to treat arrhythmia. ICD is more commonly used in patients who have had episodes of ventricular fibrillation (VF). VF is a severe twitching of the heart that contributes to cardiac arrest because blood isn’t being pumped out of the heart.
An implanted defibrillator delivers an electrical current to the heart to restart the muscle in the event of VF or other forms of arrhythmia. An ICD is implanted under the skin, usually in the area below the collarbone or the abdomen. Wires are threaded from the ICD battery pack to inside the heart muscle