Providence understands that proper care is critical when it comes to potentially life-threatening conditions. Arrhythmia, or irregular heartbeat, is such a condition: without medical therapy or intervention, it can diminish quality of life or result in sudden cardiac death. If you live with arrhythmia, your doctor may determine that an implantable device is the best method to manage it.
An implantable cardioverter defibrillator (ICD) is an electronic device that monitors the heart rate and rhythm and delivers energy to the heart muscle when it detects an abnormal rhythm. The generator is two thirds the size of a deck of cards and is implanted under the collarbone. One or two wires connect the heart and the device through a large vein. These wires transmit heart rhythm information to the generator, which processes the input and decides whether a pacing therapy or shock is necessary to restore normal beats.
Primary candidates for ICDs include patients with previous episodes of sudden cardiac death or ventricular fibrillation, previous heart attack victims at high risk for sudden cardiac death, patients with hypertrophy cardiomyopathy, or patients with at least one episode of ventricular tachycardia.
The ICD is programmed to include one or all of the following functions:
- Anti-tachycardia pacing
- Bradycardia pacing
Since implantation is a surgical procedure, the patient stays in the hospital for a few days to recover and to determine if the ICD needs to be electronically adjusted. During this time, the patient and family members receive instructions regarding special considerations to be taken after discharge from the hospital.
Using a small, battery-powered generator to deliver timed, electrical impulses to the heart muscle through tiny wire leads, a pacemaker helps the heart beat in a regular rhythm.
Traditional pacemakers may have one lead pacing only the ventricles or the atria or two leads pacing both chambers. A biventricular pacemaker is a more recent innovation in the treatment of arrhythmias that uses three leads to treat the delay in heart ventricle contractions. This new therapy improves the symptoms of heart failure and increases the patient’s overall quality of life.
Primary uses for pacemakers include the treatment of:
- Heart failure
- Hypertrophic cardiomyopathy
Pacemakers are typically implanted under local anesthesia.
Once in place, information from the pacemaker can be sent from the telephone or home monitoring system to the doctor's office. If adjustments need to be made, they will be taken care of in your doctor's office.
A ventricular-assist device (VAD) is a mechanical heart pump that is surgically implanted in the body. The device helps a weak heart by pumping blood for the heart.
Surgery to implant a VAD is like other forms of open-heart surgery. Once the chest has been surgically opened, one end of the VAD is sewn into the tip of the heart, and the other end is sewn into the aorta. A driveline, a tube that contains the electrical wire to run the pump, comes out of the skin on the left side of your abdomen. The pump is attached to your heart and takes the blood into the device and pumps it to the body through another tube attached to your aorta.
Watch an animation to see how the VAD works.
The VAD has four main parts:
- The implanted blood pump
- A tube that passes out of your body on the left side of your abdomen (driveline)
- A small computer (controller) that controls the pump’s operation.
- The external power source (battery or plugged into power outlet)
Occasionally, other types of heart surgery (bypass surgery, valve surgery) are performed at the same time as the VAD is implanted. Surgery usually takes six to ten hours. After the surgery, patients recover in the intensive care unit for several days.