Robert Chilton, DOCardiology Interventional Cardiology
When your heart beats irregularly, it could cause some serious health problems. Electrophysiologists at University Health might recommend device implantation to get your heart back in rhythm.
You can develop a slow heart rate in the top chamber, or an electrical block can occur between the top and the bottom chambers, causing complete heart block. In these cases, your doctor will implant a pacemaker.
Your doctor may recommend the His bundle or left bundle pacemaker implantation.
The biventricular pacemaker implantation is offered for patients with heart failure.
Fast heart rhythms originating from the bottom chamber of the heart are called ventricular tachycardia. These are life-threatening rhythms. To treat these, your doctor will implant a cardiac device called a defibrillator. The defibrillator will shock your heart back to its normal rhythm.
Our electrophysiologists offer several type of implants that include:
- Transvenous defibrillator implantation
- Subcutaneous implantable cardioverter defibrillator (ICD) implantation
- Biventricular ICD implantation
In transvenous cardiac device implantations, the leads or wires are implanted into the top and bottom chambers of the heart. The pacemaker battery is placed in the pocket on the side of the chest.
A subcutaneous ICD is a device your doctor will implant under your skin. It continuously monitors your heart rhythm and will send electric shocks to the heart muscle when it detects an abnormality. This shock will restore your heart to a safe, normal rhythm.
If your heart beats very fast, your doctor may recommend this device. The subcutaneous ICD uses leads that are implanted under the skin instead of into the veins, which is the traditional method. Implanting the leads under the skin makes it easier for your doctor to remove or replace them.
A leadless pacemaker is a small device implanted in the right ventricle of the heart. It sends small electric pulses to the heart to help maintain your heart’s rhythm. If you have an abnormally slow heart rhythm, your doctor may recommend this device.
Unlike a traditional pacemaker, a leadless pacemaker does not use wires or a generator, which can cause complications. Your doctor will insert the leadless pacemaker using a catheter to access your heart through a vein.
An implanted device may have to be removed if there is a failure of the device system or if there is an infection. University Health is a certified Lead Extraction Center. Our electrophysiologists perform lead extraction with a surgical backup in the hybrid operating room. We use different lead extraction tools like the laser, and mechanical extraction tools are available.
Cardiac Resynchronization Therapy
Patients with heart failure who have optimal medical management may benefit from cardiac resynchronization therapy. This involves placing three wires into the heart to help restore your heart’s normal rhythm. This is called the biventricular pacemaker or ICD.
Devices Reduce the Risk of Stroke in People with A.Fib
Because people with atrial fibrillation (A.Fib), the most common type of arrhythmia, have a higher risk of stroke, they may have to take blood-thinning medications. However, blood thinners can be dangerous for some people, such as those with a high risk of bleeding.
Implantable devices can be used to seal off the heart’s left atrial appendage, where most stroke-causing blood clots form. These devices do not treat the heart’s electrical system. Instead, they reduce the risk of stroke for people with A.Fib.