Cardiac Device Implantation

These include permanent pacemakers (PPM), implantable cardiac defibrillators (ICD) and cardiac resynchronisation therapy (CRT).

PPM & ICD device implantation is recommended if there is evidence of a dangerous heart rhythm. A CRT is indicated in severe heart failure to attempt to improve heart function. A CRT can have ICD capability if required.

A PPM is a small electrical device, fitted in the chest, usually the left side, connected to one or two leads in the right side of the heart. It is used to treat abnormal heart rhythms that cause your heart to beat too slowly. It works by delivering an electrical impulse to make your heart beat if your own cardiac electrical system is not functioning normally. Most PPM work just when they’re needed – on demand. Pacemakers do not give your heart an electrical shock.

An ICD is a device which is recommended in people with dangerously abnormal heart rhythms that could lead to a cardiac arrest. It sends electrical pulses to regulate abnormal heart rhythms, specifically those that can be dangerous and cause a cardiac arrest. An ICD is placed under the skin to monitor your heart rate, with wires connecting it to the heart. An ICD constantly monitors your heart rhythm through these wires. If an ICD notices a dangerous heart rhythm it can deliver one or more of the following treatments:

  • Pacing – a series of impulses (paced beats) at a fast rate to try and correct the heart rhythm.

  • Cardioversion – one or more small electric shocks to try and restore the heart to a normal rhythm.

  • Defibrillation – one or more larger electric shocks to try and restore the heart to a normal rhythm.

Devices are usually fitted under local anaesthetic. A small incision is made in the skin. The leads are inserted through a vein and positioned in the heart. These are then connected to the device, which is placed under the skin.