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Pacemaker and defibrillator checks


Patients who have degeneration of the heart’s electrical system (called conduction system disease), can often experience dizzy spells or sudden blackouts. Treating this problem requires implantation of a permanent pacemaker, which is a small electronic device placed under the skin below the left or right collar bone. The device has one or two electrodes that run down a vein into the heart, and these electrodes deliver a small electrical impulse which is not felt by the patient but which mimics the normal heart beat. Implantation can be performed under local anaesthetic and usually requires only an overnight hospital stay.
In some patients with severe heart muscle weakness (called cardiomyopathy), a more sophisticated pacemaker can be implanted. This is called a Biventricular pacemaker, and it has an extra lead tracking down into the heart. A biventricular pacemaker, apart from having normal pacemaker functions, has the effect of boosting the heart’s pumping strength which has been shown to improve patients symptoms as well as long term outlook. It is important to note that not all patients with cardiomyopathy will benefit from this type of a pacemaker.
Another type of implantable device is called a defibrillator, and this can be either a stand alone device or also include Biventricular pacing functions. Defibrillators are implanted in people who have experienced life threatening heart rhythm abnormalities or are deemed at risk of experiencing such a problem based on the severity of underlying heart disease.
All these electronic devices need to be checked by a cardiologist usually every 6 or 12 months to ensure that they are operating appropriately, that they are ideally programmed for the patient’s particular problem and lifestyle, and that the battery is not running out. Pacemaker batteries usually last from 7 to 10 years, although later models may last up to 14 years. Batteries in defibrillators do not last as long. When a check reveals that the battery is becoming depleted, arrangements will be made to remove the old device and implant a new one. It is important to realise that these device batteries do not suddenly wear out, and replacement can be planned at a convenient time for the patient within a few months, provided the routine checks are performed.