Most of us have heard of a pacemaker – a device capable of providing electrical stimulation to the heart – but do you know what an ICD is? An ICD, or implantable cardioverter-defibrillator, is a device capable of detecting and terminating tachycardia/fibrillation by delivering a high-energy electrical shock. ICDs are implanted exactly like a pacemaker, under the clavicle. Pacemakers and ICDs require little maintenance but need to be replaced every six to 10 years. These devices are very safe; less than one percent experience a complication like infection.
“How we decide which one is needed for a patient is based on their EKG and heart function, so that shows us who will qualify and which device best fits their needs,” Blount Memorial board-certified and fellowship-trained interventional cardiologist Dr. Emad Dodin said. “A normal heartbeat is 60-100 beats per minute, and we don’t usually want it lower than 60 with few exceptions. These pacemakers are programmed to keep watch for electrical activity inside the heart. If it doesn’t see that electrical activity or pulse at least once every second, the pacemaker kicks in. If the heart is not being stimulated, it will stimulate it,” Dodin explained.
After implantation of a pacemaker or ICD, patients are asked to follow up every six months to a year, depending on their disease and condition. The physician will ask about symptoms, check the device and adjust it as needed. “There’s also a wireless bedside monitor that communicates with the pacemaker or defibrillator. It detects if there is a malfunction, be it the pacing function or defibrillation, and it sends an alert to the manufacturer and to the physician who follows up on the patient. If the alert is life-threatening or critical, we get informed immediately so we can take action,” Dodin added.
Dodin explains that “rate response” technology monitors heartbeat and breathing. “These devices mimic human heartbeats, and different devices have different functions and different errors. They can even tell us if the patient is about to go into heart failure, and it would send us a signal. These devices are being monitored 24 hours a day – it’s amazing.”
The team at Blount Memorial Physicians Group – Cardiology continues to implement new technologies to help with complex cases. “Technology is improving and becoming more delicate. An interventional program like ours takes more high-risk and complex cases, and experience with these devices makes us even more able to deliver complete care for patients. We have implanted the first small pacemaker inside the heart, called a micra device. These latch right onto heart muscle and last for about 12 years. There are no incisions, and patients go home in about two hours. The advantage of this is that you don’t have cables, you don’t implant in the chest and you don’t leave a scar. They’re not suitable for everyone, but are perfect for some patients,” Dodin said.
For more information about these devices or to make an appointment, contact Blount Memorial Physicians Group – Cardiology at 865-238-6161.
