What is a pacer or ICD implant?
A pacemaker, or an implantable cardioverter defibrillator (ICD), are surgically implanted, battery-operated devices that track arrhythmia or inconsistent heart rhythm. Pacemakers are devices implanted primarily to assist with the preservation of a normal heart rate, as a slow heart rate can cause symptoms of fatigue and dizziness, or even cause you to pass out. Unlike ICDs, pacemakers only have two functions:
- To cause your heart to beat
- To watch your heart beat
Pacemakers are not only placed in patients with a slow heart rate, but also to monitor any interruption of the electric pathway between the top and bottom chambers of the heart, known as complete heart block. Pacers are most commonly implanted for Sick Sinus Syndrome, in which the heart beats both too fast and too slow. In this situation, medications are utilized to slow down the fast heartbeats, while the pacer supports the lower heart rate.
ICD devices not only perform all the functions of a pacemaker, but also provide life-saving defibrillations to convert an erratic heart beat back to normal. These devices are composed of a small box that produces an artificial electrical shock, connected to two lead wires that transfer this electricity to the heart. ICDs are used to prevent sudden cardiac death. Sudden cardiac death is caused by an abrupt loss of electrical activity within the heart, which, when healthy, works in sync to pump blood through each chamber and out to the body.
Where does the Pacer or ICD go?
During this routine heart surgery, Dr. Ginkel will place your pacer/ICD implant in one of two spaces – under the skin or chest muscle just below the clavicle, or under the skin of the abdomen. When placed below the clavicle, lead wires will thread through your subclavian vein and superior vena cava leading to your right atrium and ventricle.
Inside your heart, there are two sets of twin chambers: the top chambers of the heart have two atria, and the two lower chambers are called ventricles. At the top portion of the right atria is an important area of tissue we refer to as the sinoatrial node (or SA node), which is where all electrical activity originates – it’s your body’s natural pacemaker. When functioning properly, the SA node directs the heart to pump your blood in a specific rhythm and rate. This transfer of electricity then moves from the right atrium to the left atrium through another area called the atrioventricular node (AV) and then a network of fibers within the heart walls, which directs the ventricles to pump shortly after the atria.
When this system functions as it should, the heart pumps in rhythm, and there is no need for concern. However, once any change in this rhythm begins, it is important to reach out to Dr. Ginkel to diagnose the origin of the issue as soon as possible.
Who needs an ICD implant?
- People that are at high risk for sudden cardiac death
- People who have survived sudden cardiac death
- People with a naturally weak heart or those who have a damaged heart from prior heart attacks
- People that are exposed to these conditions by genetics (familial cardiomyopathies)
Patients who benefit from pacer/ICD implants are often discovered while undergoing routine testing. The sooner you come in for a cardiac consultation with Dr. Ginkel, the higher your chances are of catching this issue. Dr. Ginkel will explain the process, and decide if you need a pacer based on your conversation and further inspection of the heart muscle. To schedule your cardiac consultation and be proactive about your heart health, call Midcoast Cardiovascular today at 805-354-0112.