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Most common heart-related conditions

- provided by America's leading cardiologists

Pacemakers and Defibrillators

Heart disease is a leading cause of death for Americans, but with education and awareness, you can take healthy steps to keep your heart in good shape. Reducing risk factors, carefully planning and following a healthy diet and even simple exercises can help you avoid the dangers of heart disease.

 


Pacemakers


What is a Pacemaker?
A pacemaker is a battery-powered device that sends signals to the heart to help it beat properly. Tune in to find out more about these life-saving devices.

Participants:
Melanie Gura, MSN
Douglas P. Zipes, MD

Webcast Transcript:

ANNOUNCER: Everyone has heard of pacemakers, but most people don't know what an important role a pacemaker can play in maintaining a healthy heart and lifestyle.

MELANIE GURA, MSN, RN: An artificial pacemaker is a small, battery-operated device that can actually take over the role of the heart's electrical system when needed. It consists of the wire, or the lead electrode system, and the pacemaker or device itself.

The population for pacemaker implantation is not limited to age, sex or race. There are approximately 100,000 pacemakers implanted yearly in the United States, and they may be prescribed for a variety of conditions.

Bradycardia is the most common rhythm problem that is associated with pacemaker implantation. This is when the heart becomes too slow, and patients have symptoms such as shortness of breath, fatigue, dizziness, or even fainting spells can occur.

Atrial fibrillation is a very common heart rhythm disorder in which the upper chambers of the heart beat erratically and chaotically and rather fast, and sometimes it's also too slow.

Heart failure is a condition in which the heartbeat cannot meet the normal volume of blood and oxygen to supply all parts of the body.

Syncope, also known as a common faint or passing out, is usually less severe, but can occur frequently in patients.

ANNOUNCER: Surgery is usually the next step to regaining a healthy heartbeat.

DOUGLAS P. ZIPES, MD: A pacemaker is put in under local anesthesia. So we make a tiny incision in the chest, and the actual procedure itself lasts 45 minutes to an hour and a half, depending upon what is done. This is certainly not open-heart surgery. It's very simply done.

MELANIE GURA, MSN, RN: Implanting a pacemaker has very little risks associated. But however, whenever there is a surgical procedure, complications can arise. One of the complications that can happen in the early postoperative phase can be bleeding at the incision and sometimes it will cause a hematoma or a little blood clot over the pulse generator and some bruising.

Rarely, a lead can become dislodged or displaced, and the patient would have to go back to have the lead repositioned by the physician

DOUGLAS P. ZIPES, MD: The complication rate is very, very acceptable, considering the tradeoff of the wonderful things the pacemaker does.

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What are the Different Types of Pacemakers?
A pacemaker is an implanted device that helps the heart beat more regularly. Learn more about the different kinds of pacemakers and the heart problems they are used for.

Participants:
Jamie B. Conti, MD

Webcast Transcript:

ANNOUNCER: A pacemaker is a battery-operated device that is implanted in the chest to help the heart pump blood more effectively. There are different kinds of pacemakers, and it's important to know what they are and what conditions they are used for.

JAMIE B. CONTI, MD: There are a variety of pacemakers that are available. There are single-chamber pacemakers, which means a pacemaker with one wire. Those are used in patients who rarely have a problem, but occasionally need a little bit of extra help keeping their heart rate up.

There are two-chamber pacemakers, which are used for people who in general need considerable support of their heart rate with a pacemaker, and one of those wires goes in the top chamber, the atrium; the other wire goes in the bottom chamber, the ventricle.

There are also three-lead pacemakers that are relatively new. Those are used to treat congestive heart failure. One of those leads goes in the atrium, the top chamber. The second lead goes in the right ventricle, which is one of the bottom chambers. And the third lead goes through a vein that wraps around the heart and can pace the left ventricle and thus help us with our treatments of congestive heart failure.

Once you have a pacemaker, it is important to follow up with your physician on a routine basis. We need to see our patients physically in our office at least once a year, and then we check their pacemaker over the telephone at a set schedule, depending on how old the pacemaker is. The older it gets, the more frequently we check it so that we know when the battery needs to be changed.

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How will Life Change with a Pacemaker?
After a pacemaker is implanted, a patient may need to make some changes in his lifestyle to prevent adverse effects. Tune in to learn more about managing life with a pacemaker.

Participants:
Douglas P. Zipes, MD
Jamie B. Conti, MD

Webcast Transcript:

ANNOUNCER: After pacemaker implantation, there are important steps and precautions patients must take to ensure that their pacemakers continue to function properly.

DOUGLAS P. ZIPES, MD: After the pacemaker is implanted, the symptoms produced by the slow heartbeat or the fast heartbeat should be taken care of by the pacemaker; that's the reason for the implantation. And then we follow the patient. Many of the follow-ups are done electronically or over the telephone so the patient does not have to come in physically to be evaluated.

With other patients, they indeed do need to come in. They may have what we call comorbidities. In other words, they have another problem, heart failure or coronary disease, that needs to be followed as well as just having the pacemaker.

ANNOUNCER: And after several months of limiting physical activity, patients can usually resume their normal routines.

DOUGLAS P. ZIPES, MD: We generally restrict an individual from major arm movements, such as lifting your arms above your head, combing your hair, playing golf, because that movement can make the wire in the heart move and change its position. After several months, that's no longer an issue, but until that time we generally want an individual to just kind of restrict their upper arm movement.

JAMIE B. CONTI, MD: People often ask, you know, "What can I do after I have a pacemaker implanted? Will I be limited in any way?" We have patients whose heart rates were so slow because of being marathon runners or extreme sports people. When they get their pacemaker, they can go back to regular activity.

ANNOUNCER: Although microwave ovens and other household appliances no longer affect people with pacemakers, there are still precautions to take in public places.

DOUGLAS P. ZIPES, MD: A couple of cautionary things. One is when you go to the airport, notify the airport security as you're going through the detector that indeed you do have a pacemaker implanted, because it can set off the alarm. The other is, there are theft detector electronic equipments that are found in department stores and bookstores and so on, and they will have no impact on the pacemaker if the individual just takes a leisurely stroll through the theft detector equipment, but we would not want the individual to stand right within that field and be exposed to it
ANNOUNCER: In the end, a pacemaker will help a patient live a more normal and active life, with little to no inconvenience.

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Implantable Cardioverter Defibrillator (ICD)


Why do I need an ICD?
When severe arrhythmias which are abnormal heart rhythms occur, a device called an implantable cardioverter defibrillator or ICD is sometimes used. Tune in to learn more.

Participants:
Alfred A. Bove, MD, PhD, FACC
Chief of Cardiology; Temple University Medical School
Jacqueline A. Noonan, MD, FACC
Pediatric cardiologist, University of Kentucky College of Medicine, Lexington, Kentucky
Mandeep R. Mehra, MBBS, FACC
Professor and Head of Cardiology, University of Maryland, Baltimore, MD

Editorial Consultant:
Suzanne Hughes, MSN, RN

Webcast Transcript:

The transcript of this event will be available shortly. Please return back in a few days.

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The information published on this page has been provided by the Heart Authority
in collaboration with Cardiosource – American College of Cardiology
Copyright 2005 Whitby Cardiovascular Institute. All rights reserved.