Cardiac devices may be needed for patients presenting with heart blocks or heart failure. These heart blocks are different from heart attack related blocks, which are due to blockages in the blood vessels of the heart. These heart blocks happen secondary to a problem with the electric system of the heart. Certain types of heart blocks may cause very low heart rate or electrical disconnection of upper and lower chambers of the heart, which requires emergency treatment.
- Emergency: Temporary pacemakers may be inserted as an emergency strategy in a patient with very low heart rate or electrical disconnection between upper and lower chambers of the heart. These can be kept for a short duration, during which the other problems of the patient may be taken care of. Once the patient is stable enough to undergo permanent device implantation, the temporary pacemaker may be removed.
- Elective: The patients may have heart block or heart failure for which these devices are required.
- Pacemaker: This device helps the heart to beat at a certain heart rate. It will be required in the patients with very low heart rate or electrical disconnection between upper and lower chambers of the heart. This device is available in two main forms – with a single wire or two wires inside the heart (single or double chamber pacemaker)
- Implantable Cardioverter Defibrillator (ICD): This device may be required for certain patients who have specific types of heart rhythm problems with/without decreased pumping capacity of the heart. It looks like a pacemaker but is slightly bigger in size.
- Cardiac resynchronization therapy (CRT): This is a special device which is used in a patient with low heart pumping capacity and may help improve the life span of the patient.
Procedure of Device Implantation
While implanting a cardiac device, a small cut is required to be made on the skin. The device can be implanted on the right or the left side of the body on the chest area.
A small area is created just below the skin for the device to be kept inside
One/ two/ three wires (leads) are then inserted inside the heart as per the type of the device
The wires (leads) are connected to the device and skin cut closed