Cardiac implantable electronic devices, including pacemakers, implantable cardioverter defibrillator (ICD), biventricular pacemakers, and cardiac loop recorders, are designed to help control or monitor irregular heartbeats in people with certain heart rhythm disorders and heart failure.
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If you have received a diagnosis of bradycardia, ventricular arrhythmia, or a supraventricular arrhythmia such as atrial fibrillation and atrial flutter, your doctor at NYU Langone’s Heart Rhythm Center may recommend that you receive one of these devices.
After the device is placed, it continuously collects information about your heart rhythm. This information is transmitted wirelessly to our cardiac device team, either automatically, through prescheduled transmissions, or manually, when you notice symptoms. Remote monitoring allows us to review your heart’s electrical activity as needed, without the need for a doctor’s visit.
People with advanced heart disease, heart failure and certain genetic arrhythmias are often at risk of life-threatening, fast, irregular heartbeats called ventricular arrhythmias. These people may need an ICD, which delivers an electric shock to restore a normal heart rhythm.
An ICD is often recommended for people with ventricular arrhythmias that have not responded to other treatment, such as catheter ablation or medical therapy.
There are two kinds of pacemakers. The traditional model is placed under the skin and connects to the heart via electronic leads. A smaller, leadless pacemaker is placed inside the heart and does not require transvenous leads.
Pacemakers are used to manage bradycardia, a condition that causes the heart to beat too slowly—less than 60 beats per minute. The pacemaker produces electrical pulses that keep the heart beating at a normal rate.
A biventricular pacemaker works like a conventional pacemaker but uses a third wire to send electrical impulses to the heart to resynchronize the contractions of the heart’s left lower chambers, or ventricles.
Also called a cardiac resynchronization device, a biventricular pacemaker is implanted when medications don’t relieve symptoms of heart failure, a condition in which the heart does not pump a sufficient amount of blood to the body, and when the left chamber does not beat in a coordinated manner. This causes the two ventricles to contract out of sync with one another. A resynchronization device coordinates the contractions of the left ventricle.
There are also biventricular defibrillators for people who would benefit from resynchronization yet also require the protection of a defibrillator. This combination device works to maintain a steady heartbeat and either speed up or slow down a heart that is beating too slow or too fast. It also records information about your heart rhythm, so our specialists can evaluate your heart health and adjust treatment as needed.
Your cardiac electrophysiologist may recommend implanting a wireless cardiac monitor called a loop recorder. This device continuously records information about your heart’s rhythm for up to three years.
Smaller than the size of a AA battery, the implantable cardiac loop recorder is inserted beneath the skin of the upper chest to record information about the heart’s electrical activity, much like an electrocardiogram, or EKG. It is used to diagnose or identify the source of an arrhythmia.
People who have had unexplained fainting spells or heart palpitations that can’t be detected by short-term heart rhythm recording devices—such as Holter monitors—may be candidates to receive this device. Doctors may also recommend an implantable cardiac loop recorder for people with atrial fibrillation, which causes a rapid and irregular heartbeat. This device is also used in people who have had a stroke for which a cause has not been determined.
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