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Treating Arrhythmias with Pacemakers and Debrillators



If your doctor decides you need a pacemaker or an implantable defibrillator (ICD), the procedure will be done in the cardiac EP lab at Central Baptist Heart & Vascular Institute.

A pacemaker is a small, lightweight electronic device surgically inserted into your body that helps the heart’s electrical system keep beating at the right pace.  The pacemaker ensures that the heart will keep beating fast enough to meet the needs of your body.  With a pacemaker, one, two or three leads (wires) are attached to the heart. The device sends electrical signals through these leads to the heart to make it beat.  This is called “pacing.”

 

                       

Implantable cardioverter-defibrillators (ICDs) are like pacemakers with extra features.  They can be used to treat more dangerous, potentially life-threatening heart rhythms, such as ventricular fibrillation (rapid, irregular twitching of the bottom chambers of the heart).  ICDs recognize dangerous heart rhythms.  If the rhythm becomes too slow, the ICD sends out “pacing” impulses to bring it back up to speed.  If the rhythm becomes too fast, the ICD may either send impulses to slow it down, or it may shock the heart to allow it to return to normal rhythm.


Implanting a pacemaker or ICD is a minor operation. The device is implanted under the skin in your chest. You will be given medication to make you very sleepy, and local anesthesia will be used to numb the area where the doctor will make the incision.  A 2-4" incision is made in the skin under the collarbone. Then a space, called a pocket, is created. The device fits snugly inside this pocket. Thin lead wires are placed through a vein into your heart.  One end of the wire is attached to your heart and the other end is attached to the device.  These wires allow the device to communicate with your heart to recognize what it is doing, and to send the necessary electrical impulses to the heart.  Pacemakers and ICDs take 60-90 minutes to implant. Afterward, you will stay in the post interventional unit for a day or two while you recover. Your doctor will make sure the device is working properly before you leave the hospital.


GUIDELINES FOR PEOPLE WITH PACEMAKERS or ICDs

It is safe to be around or use any of the following:

  • Microwave ovens, blenders, vacuum cleaners
  • Cellular telephones
  • Electric razors, hair dryers, electric toothbrushes
  • Television sets, CD players, radios


The following should be avoided and are not safe for pacemaker or ICD patients:

  • Medical imaging with an MRI (magnetic resonance imaging)
  • Magnetic devices should not be placed within six inches of your ICD (unless you are undergoing testing in our clinic)
  • The distributor or coil of a gasoline engine while the engine is running
  • SCUBA diving to depths in excess of one hundred feet
  • Arc welding (unless certain precautions are taken as directed by your physician)

It is safe to pass through airport security systems and anti-theft devices at department and retail stores. You should avoid standing inside these gates. You should move through them without stopping. If it is necessary for the security guard to pass a detection wand over you, make sure you tell them you have a pacemaker or ICD & ask them not to put the wand directly on top of the device.

Notify any physician or dentist who provides treatment to you that you have a pacemaker or ICD. This will allow them to take special precautions for certain types of procedures.


WHAT SHOULD I DO IF I GET SHOCKED:

A shock from an ICD will probably take you by surprise. You should try to sit down and rest for a while. You may feel dizzy, sick, or disoriented.  Try to remember to do the following:

  • Stay calm.
  • Sit or lie down. Ask someone to stay with you.
  • If you do not feel well after the shock, call your doctor or an ambulance (Dial 911).
  • If you get one shock and feel fine afterwards, you do not need to seek immediate medical attention, but do call your doctor within 24 hours.


 CONTACT YOUR DOCTOR IMMEDIATELY IF:

  • You receive two or more shocks in a 48-hour period.
  • You lose consciousness before receiving a shock.
  • You have numbness, swelling or tingling of the arm or hand on the side of your ICD
  • Twitching chest or abdominal muscles
  • Frequent or constant hiccups