Overview of Pacemakers and ICDs
To correct abnormal heart rhythms (arrhythmias) and help your heart beat more efficiently, your doctor may recommend a device implant. The most common device implants are pacemakers and implantable cardioverter defibrillators (ICDs). These devices are usually implanted in the cath lab but may also be implanted during surgery.
Pacemakers: Pacemakers are usually used to correct heart rhythms that are too slow or are out of synch. A pacemaker typically has two parts: a pulse generator, and one or more leads. The pulse generator includes a battery and circuits that create electrical pulses. The leads are wires that send the electrical pulses to your heart.
Implantable Cardioverter Defibrillators (ICDs): ICDs are used to prevent or treat fast or chaotic arrhythmias called ventricular tachycardia (v-tach) or ventricular fibrillation (v-fib). Here's how they work:
- If your heart begins to beat abnormally fast, the ICD first alters the pacemaker's speed to bring the heart back to a normal rhythm. This is called antitachycardia pacing, and you won't feel anything while it happens. If this doesn't work, the ICD sends a low-energy electrical impulse (shock) to your heart at the same time as your regular heartbeat. This is called cardioversion, and you may feel this.
- If your heart is beating dangerously fast or chaotically, the ICD sends a high-energy shock to your heart muscle to restore a normal rhythm. This is called defibrillation. You will probably feel quite a jolt when this happens.
Pacemakers and ICDS are placed in a small pocket under the skin below the collarbone. Leads are threaded through a vein in the upper chest and guided to the heart with the help of x-ray monitors.
- For the battery: Every 4 to 10 years or so, a pacemaker or ICD may need to be removed for battery replacement — and then re-implanted.
- For the leads: If a cardiac lead or pacemaker lead is infected, not working, or surrounded by too much scar tissue, it may need to be removed. Laser lead extraction uses special catheter-guided lasers. Controlled laser energy is used to free the lead from surrounding scar tissue. This lets the doctor safely remove the lead with little risk of damaging the heart.
Pacemakers and ICDs In Depth
Learn more about pacemakers and ICDs from Intermountain's Patient Education Library:
Learn what happens (and what you need to do) before, during, and after this procedure:
Where do I go?
Pacemakers and ICDs are implanted in the Cardiovascular Cath Lab. On the day of your procedure, you need to come to Intermountain Medical Center – Building 4 (Heart & Lung Center). Follow the signs to Patient Registration on the first floor. We will greet you and take you to a room in our Cardiac Procedure and Recovery Unit. When it is time for your procedure, you will be taken to the Cardiovascular Cath Lab.
If you have questions please call us: 801-507-4701.
Learn More About Our Heart Rhythm Program