Pacemaker/ Defibrillator Implant

Pacemakers and implantable cardioverter defibrillators (ICDs) are surgically embedded devices used to manage heart conditions. While both devices work to improve the patient’s quality of life, they are not the same.

What is a Pacemaker?

A pacemaker is a small device used to help regulate an erratic heartbeat. Pacemakers replace the heart’s natural pacing functions by receiving and sending electrical signals to monitor the heart rate. A pacemaker is composed of a pulse generator and one or more leads. The pulse generator houses the battery and the electrical panel that regulates the pulses sent to the heart. The leads are insulated wires that deliver electrical pulses to adjust the heart rate.

Depending on your condition, your doctor may suggest one of the following types of pacemaker devices:

• Single-chamber pacemaker. This type of pacemaker has one lead that connects the pulse generator to one chamber of your heart.
• Dual-chamber pacemaker. This type of pacemaker has two leads that connect the pulse generator to both chambers of your heart.
• Biventricular pacemaker. This pacemaker, also known as a cardiac resynchronization therapy (CRT) device, has three leads connected to the right atrium and both ventricles.
• Single-chamber leadless pacemaker. This type of pacemaker is placed directly in your heart and connects directly with the heart muscle.  No lead is used in this type of device.

Typically, your doctor might prescribe a pacemaker if your heart beats too slowly or if you have certain types of an irregular rhythm. However, pacemakers may also be necessary if you have had an ablation procedure or take certain heart medications. 

Your cardiologist will make an incision just below the collarbone on your chest (right or left) side during the procedure.  The pacing leads are then inserted into a vein underneath the collarbone and guided to the heart’s correct chamber using x-ray technology. The other ends of the leads are connected to the pacemaker before placing the pacemaker in a small “pocket” in the chest underneath the skin. The procedure is performed under local anesthesia and typically takes about one hour. 

Complications from surgery to implant your pacemaker are uncommon but could include:

• Bleeding from the incision or catheter insertion site
• Damage to the vessel at the catheter insertion site
• Infection of the incision or catheter site
• Pneumothorax

What is an Implantable Cardioverter Defibrillator?

An Implantable Cardioverter Defibrillator (ICD) is a small, computer-based device used to monitor your heart rate. Because many ICDs include built-in pacemaker functions, they can perform all the primary tasks of a pacemaker. The key difference is that an ICD can also deliver an electrical shock to the heart to restore a normal rhythm if it begins beating chaotically.

Your doctor might prescribe an ICD if you have experienced ventricular fibrillation, ventricular tachycardia, cardiac arrest, or have sustained damage to your heart muscle that puts you at risk for these rhythm disturbances.

The procedure to implant an ICD is identical to that of a pacemaker. As with pacemakers, some ICDs connect directly to the heart using leads, while others are "leadless."

Potential Complications

While complications from surgery are uncommon, they can include:

• Bleeding from the incision or catheter insertion site
• Damage to the blood vessel at the catheter insertion site
• Infection of the incision or catheter site
• Collapsed lung
• Dislodging of the leads

Post-Procedure Care

After receiving a pacemaker or an ICD, it is essential to discuss and understand your healthcare provider’s instructions regarding:

• Activity limits
• Driving
• Medications
• Necessary precautions
• Follow-up appointments
• Device monitoring

Request an Appointment

Whether you need a pacemaker, an ICD, or both, Baptist Health is here to help. Call Baptist Health Healthline today to request an appointment with one of our heart specialists.