Implantable Cardioverter Defibrillators (ICDs) and Pacemakers
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Implantable devices can send a signal to the heart when it is beating slowly or irregularly (pacemaker), or an electrical shock when it is beating rapidly or erratically (ICD).
These interventions are sometimes paired with other arrhythmia therapies, and can also provide an option when other treatments are not working.
They can relieve symptoms and, in some cases, protect you from conditions that could threaten your life.
Implantable Devices at University of Maryland
We provide a comprehensive range of implantable devices to treat arrhythmia, as well as all needed support services.
Our program offers:
- Deep experience: Our doctors implant hundreds of pacemakers and ICDs per year. They also know how to successfully treat a wide variety of arrhythmias, including those associated with complex diseases present at birth.
- Treatment choices: We offer an extensive list of devices for treatment, with remote monitoring by our team to provide top care. The University of Maryland uses the most sophisticated pacemaker technology, including leadless pacemakers (a smaller model which is implanted via a catheter and is self-contained in the heart), multi-site pacemakers and biventricular pacing devices. Read about the latest leadless pacemaker (the Micra) that the University of Maryland's arrhythmia team is implanting.
- Specialized repairs: Many medical offices can implant devices for basic arrhythmias. But we are among the few programs in the region that also troubleshoot device problems and fix the wires (leads) that run to the heart. We often receive referrals to do so from outside doctors.
- Leading research: We conduct studies on new devices, and offer appropriate patients the chance to join clinical trials.
What is a Pacemaker?
A pacemaker is a small device that runs on batteries and is implanted under the skin, usually on the left side of the chest below the collarbone. Doctors thread wires (leads) through veins, connecting the device to the outside of the heart.
Pacemakers sense when the heart is beating slowly or irregularly, then send out a signal to correct the pace.
What is an Implantable Cardioverter-Defibrillator (ICD)?
An ICD is a pocket watch-size generator that is implanted under your skin and muscle, usually near the left shoulder. Wires (leads) run through veins, linking the device with an electrode place on the outside of the heart.
ICDs detect when the heart is beating rapidly or erratically, then send out an electric shock (defibrillation) to restore the normal rhythm. Many newer ICDs also include a pacemaker that can help smooth the rhythm after a shock or activate if the heart beats too slowly.
ICDs are often used for the more dangerous arrhythmias that begin in the heart’s lower chambers (ventricles).
We are among the select centers in the U.S. offering a new type of ICD that avoids using the body’s veins. Instead, the wires (leads) to the heart run under the skin.
The device is not appropriate for all arrhythmias requiring an ICD — for example, it does not have a built-in pacemaker like many of today’s models. But it does provide benefits for certain cases:
- Doctors cannot use the veins to access the heart in some patients, because of structural issues, congenital defects or problems getting access.
- Some patients receive an ICD because their arrhythmia puts them at risk for sudden death, but have no need for the pacemaker component. Often, they are younger and eventually need to have their leads replaced. But doing so in the veins is much more challenging than working under the skin.
ICD Device Troubleshooting and Lead Management
We not only implant pacemakers and ICDs, but we provide a full range of device support if problems arise. We also offer all the services needed to manage the wires (leads) running from the device to heart, including removal and replacement.
Leads may require extraction because of:
- General electrical failure
We often get referrals for device troubleshooting and lead management from outside doctors.