Cardiac Device Implantation for Hypertrophic Cardiomyopathy

Doctors at NYU Langone’s Heart Rhythm Center implant cardiac devices that help maintain regular heartbeats in people with dangerous heart rhythms caused by hypertrophic cardiomyopathy. Cardiologists, device management specialists, and electrophysiologists—doctors who specialize in heart rhythm disorders—work together to help improve heart rhythm and rate.

These devices are sometimes used with medication to improve symptoms.

Implantable Cardioverter Defibrillators

The goal of an implantable cardioverter defibrillator is to detect and correct a potentially life-threatening, rapid, and chaotic heartbeat called ventricular fibrillation.

The device is implanted under the skin over the rib cage to detect irregular heartbeats that originate in the heart’s lower chambers, or ventricles, which pump blood to the body. When needed, it automatically delivers a series of pacing pulses or an electrical shock to the heart through wires called leads, correcting the heart’s rhythm. This is called defibrillation.

Many of these devices have a built-in pacemaker that sends electrical pulses to the heart when the organ beats too slowly, restoring its normal rate.

Cardioverter defibrillators are implanted through an incision in the armpit using general anesthesia. The procedure takes 30 to 60 minutes and requires an overnight stay in the hospital. For 2 weeks afterward, your doctor advises you to avoid driving and lifting items heavier than 10 pounds.

Dual Chamber Pacemaker

A pacemaker is a battery-operated device the size of two half-dollar pieces pressed together. It’s implanted in the chest and sends electrical signals to your heart through two wires called leads. A pacemaker helps correct a slow heart rhythm called bradycardia.

A dual chamber pacemaker—which has a lead that attaches to an atrium and another that’s connected to a ventricle—may be recommended for people who experience exercise intolerance or shortness of breath; for those whose symptoms aren’t relieved with medication; or for people who are not able to have open heart surgery.

Your NYU Langone heart surgeon typically makes a small incision in the armpit to implant the pacemaker under the skin below the left or right collarbone. He or she then connects the device’s leads to the heart.

The doctor administers a sedative and a local anesthetic, which is applied at the incision and implantation site. It takes 30 to 60 minutes for the doctor to complete the procedure, and you typically stay in the hospital overnight. Your doctor may restrict your activities, such as driving, for up to two weeks after the procedure.

Cardiac Device Management

If your NYU Langone doctor has implanted a pacemaker or defibrillator to manage hypertrophic cardiomyopathy, experts at the Heart Rhythm Center provide ongoing cardiac device management to ensure that the device continues to maintain your heart’s rhythm. These devices can be monitored at your doctor’s office or remotely through wireless technology.

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