Forms of heart failure, disease, and defects can become life-threatening if symptoms persist following medication or surgical treatments.
Implanted medical devices can correct certain heart conditions on a long-term basis, or may act as a transition between more serious treatment plans, such as a heart transplant. Implantable devices can be expensive—some estimate a price tag of $30,000 or more.
However, the device should be considered priceless as it can save your life.
Who Needs It
A pacemaker is perhaps the most well known implanted medical device for heart patients. This small component is surgically inserted into the abdomen or chest cavity of someone suffering from arrhythmia, or irregular heartbeat. People with heart arrhythmia may experience beating patterns that are too fast, too slow, or uneven.
Less invasive treatment methods for arrhythmia include medications, a single electric shock called “cardioversion,” or ablation therapy (a catheter procedure which destroys abnormal tissue that contributes to the irregular beating pattern). A pacemaker is the solution when these first-line treatments fail to stabilize the arrhythmia.
How It Works
The National Heart Lung and Blood Institute (NHLBI) describes a pacemaker as an internal monitoring system for your heart that measures electrical activity, beating pattern, heart rate, and even blood temperature. When your heart’s electrical system goes off track, the battery-powered pacemaker guides your heart to return to the normal rhythm with an electrical impulse. Pacemaker battery and generator lifespans average about seven years, at which time replacement may be necessary.
Surgery to install a pacemaker is performed in a hospital setting under general anesthesia. Your surgeon places the device and its battery pack under your skin and threads the wires through your veins and up to your heart. The procedure may take several hours, and you will most likely stay in the hospital overnight for monitoring. Recovery time is brief. You may experience soreness at the site of the incision for several days, but you can return to work whenever you feel ready.
Risks of pacemaker installation are low, but may include:
- swelling or bruising at the incision site
- damage to blood vessels or nerves
- collapsed lung
Heart patients who have pacemakers must be vigilant about potential interference from electronic items, such as cell phones, microwave ovens, and metal detectors. The key is to put some distance between your pacemaker and these electrical devices, i.e. carry your cell phone in a back pocket or purse rather than in a shirt pocket, and don’t stand close to a microwave for extended periods of time.
Notify personnel at airports and other locations outfitted with metal detectors and other imaging equipment, as the machinery may set your pacemaker off its charted course.
Ventricular Assist Device
A ventricular assist device (VAD)—also called a left ventricular assist device (LVAD) because it helps perform the job of the heart’s left ventricle—is a temporary measure used to prevent fatal end-stage heart failure. The left ventricle is the largest chamber of the heart, and is responsible for pumping blood from your heart to the rest of your body.
Heart patients who are on a transplant list may require an LVAD (an artificial pump) to perform the job that their heart is too weak to do. A ventricular assist device is often referred to as a “bridge to transplant,” according to the American Heart Association. The device is used as a measure to save lives until a suitable donor heart is found.
Risks of the surgery include:
- device failure
- heart failure
- blood clots
LVAD surgery is open-heart surgery spanning four to six hours. You’ll be placed on a ventilator and heart-lung machine while the device is implanted in your chest cavity. Expect to spend a few days in the intensive care unit (ICU) directly after surgery. This is to ensure your pump is working correctly, to adjust your levels of blood-thinning medicine, and to prevent infection. Recovery depends on your overall health prior to the surgery. Some patients are well enough to go home, while others must remain in the hospital until a donor heart is available.
Implantable Cardioverter Defibrillator
An implantable cardioverter defibrillator (ICD) is similar to a pacemaker in that both devices are used to treat arrhythmia. ICD is more commonly used in patients who have had episodes of ventricular fibrillation (VF). VF is a severe twitching of the heart that contributes to cardiac arrest because blood isn’t pumped out of the heart as it should. VF is often fatal, but may also occur during a non-fatal heart attack or from lack of oxygen.
An implanted defibrillator delivers an electrical current to the heart to restart the muscle in the event of VF or other forms of arrhythmia. Much like a pacemaker, an ICD is implanted under the skin, usually in the area below the collarbone or the abdomen. Wires are threaded from the ICD battery pack to inside the heart muscle.
Studies published in a 2009 issue of Archives of Neurology indicate that men are treated with ICD more often than women. Female heart patients have up to a 70 percent increase in adverse effects from ICD surgery and treatment than men. However, the difference in responses to the device may stem from fewer ICD studies containing women. More research is needed on females with ICDs.