Pacemakers
Pacemakers are recommended when patients experience fatigue, weakness, lightheadedness, shortness of breath or fainting related to slow heart rates. If a heart beats too slowly, not enough blood is pumped to meet a body’s needs.

Slow heart rates commonly result from problems in the heart’s own pacemaker—the sinoatrial node—or in the heart’s electrical system. Mechanical pacemakers are designed to help regulate the heart and maintain a natural heartbeat.

Pacemakers have pulse generators, containing batteries and electronic circuitry, which send electrical pulses to heart muscle. Pacemakers are surgically implanted under the skin, near the armpit, and are connected to the heart by tiny wires, called pacing leads. These leads send the electrical pulses to the heart, causing it to contract.

Present-day pacemakers are the size of a pocket watch. Most are “demand” pacemakers that operate only when needed. They contain sensing electronics that monitor natural heart rhythms and provide pulses only when necessary.

Most pacemakers are designed to provide up to 10 years of service to a patient. However, since they operate on batteries that will eventually run low, patients are monitored and given ample time (usually six months) to schedule replacement procedures.

It is important to periodically check pacemakers to make sure they are functioning properly, and that the settings are appropriate for a patient’s needs. The Arrhythmia Institute will schedule you for periodic follow-ups. Our doctors have special equipment to communicate with pacemakers, allowing them to adjust functions without additional surgery.

A typical follow-up visit usually includes a brief physical examination, an electrocardiogram and a detailed evaluation on how well your pacemaker is performing. It is quick and painless.

Defibrillators
There are more serious arrhythmias, often rapid and prolonged, that arise in pumping chambers damaged or scarred by heart attack. During these arrhythmias, blood pressure plummets, and the affected person can lose consciousness. Unless treated quickly, this type of arrhythmia can prove fatal.

Administering electrical shocks to the chest treats these arrhythmias. We’ve all seen TV medical shows where the doctor or nurse shouts “clear,” and electrified paddles are placed on the patients’ chest to shock them. To prevent these potentially fatal arrhythmias, our electrophysiologists use an implantable device, called a cardioverter defibrillator (ICD), to achieve the same result.

ICDs are inserted under the skin beneath the collarbone, and a wire, or lead, is passed intravenously to the heart. The device records the heart’s electrical signals, and when it detects a dangerous arrhythmia, it delivers lifesaving electrical energy directly to heart muscle, restoring a normal heartbeat.

For a referral to an electrophysiologist for a pacemaker or defibrillator at St. Luke’s and Roosevelt Hospitals in Manhattan, New York City, call 1 (877) 996-9334.