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.
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.
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.
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.
The information
published on this page has been provided by the
Heart Authority
in collaboration with Cardiosource – American College of Cardiology
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