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Pacemaker Implantation & Implantable Loop Recorders

What is a pacemaker? What is pacemaker implantation?

A pacemaker is a small implantable device that monitors and regulates heart rate. The device is implanted just beneath the skin, near the heart, in a minor surgical procedure. “Pacemaker implantation” is the surgical procedure in which the pacemaker is inserted into the patient’s body. You can learn more about this surgical procedure below.

Who needs a pacemaker?

Pacemakers are typically given to patients who have an arrhythmia (an irregular or abnormal heartbeat). In many cases, a pacemaker may speed up a heartbeat that is too slow (bradycardia) or one that alternates between fast and slow. However, even patients with atrial fibrillation (AF), a condition in which the heart beats too quickly, could need a pacemaker. In many cases, patients with AF receive a treatment, such as catheter ablation or medication. The therapy slows down the patient’s heart rate too much. A pacemaker is used to stabilize this overcorrection. Other reasons for needing a pacemaker:

  • Natural aging of the heart muscle
  • Heart block
  • Cardiomyopathy (heart failure)

How does a pacemaker work?

A pacemaker consists of a pulse generator, a lead (sometimes more than one), and one electrode for each lead. The pulse generator device is usually placed just beneath the collarbone. The device’s leads, thin insulated wires, run from the generator through a vein and into the heart. Depending on the patient’s heart condition, these electrode-tipped leads may be placed in the heart’s upper chamber, lower chamber, or both. The electrode is attached to the heart’s wall. The electrode has two functions: one, to monitor heart rate and relay this information back to the device; two, to take over pumping function if heart rate drops below a pre-set BPM threshold.

How is a pacemaker implanted?

Pacemaker implantation is typically performed as an outpatient surgery. The procedure is done while the patient is awake. During the procedure, a small incision is made on the chest through which the device’s lead wires are inserted. Using advanced imaging technology, the physician guides the lead wires through the heart into the correct chamber. Once in place, the physician will test the lead wires to ensure proper placement.

Next, the physician inserts the pulse generator device just below the collarbone, and the lead wires are attached to the generator. The device may be tested again at this time. Results can be monitored via EKG. If the interventionist is satisfied with the results, then the incision may be closed and covered with a bandage or dressing.

Many pacemakers can transmit patient information wirelessly to the cardiologist. This reduces the number of trips patients with pacemakers have to make to their physician’s office. However, routine pacemaker evaluations and occasional battery replacements are still necessary. Your cardiologist at Phoenix Heart Center can tell you more.

What is an implantable loop recorder?

An implantable loop recorder (ILR) (also known as a cardiac event recorder) is a device that records electrical activity in a patient’s heart. The device is somewhat similar to a pacemaker. One of the main differences, however, is that the ILR does not regulate heart rate. 

Who needs an implantable loop recorder?

ILR devices are typically given to patients who experience symptoms that could be heart-related, such as fainting, lightheadedness, dizziness, seizure, and frequent palpitations, but do not experience symptoms with enough regularity that they can be captured by a 24-hour to 30-day Holter monitor.

How does an implantable loop recorder work?

An ILR device can record heart rate one of two ways. When the device is placed, your cardiologist will program it to begin recording if the heart rate drops below a certain rate. The patient can also initiate recording. If you begin to feel symptoms, you can hold a special device over the implantable loop recorder to begin recording. Any information recorded – whether manually or automatically – can be accessed by your cardiologist. 

How is an implantable loop recorder placed? 

Device implantation is a simple outpatient procedure. It can be performed under local or general anesthesia. During the ILR placement procedure, a small incision is made to the immediate left of the breastbone. The device is inserted beneath the skin through this incision. Unlike a pacemaker, no leads or electrodes are necessary with an ILR.

Schedule Your Appointment With a Cardiologist in Phoenix

Has your physician suggested that you may benefit from a pacemaker or implantable loop recorder? To learn more about these options, schedule your appointment with a board-certified, fellowship-trained cardiologist in Phoenix, Mesa, or Tempe, AZ, contact a Phoenix Heart Center location near you. You can also book your appointment online.

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