What devices are used to treat arrhythmias?

What devices are used to treat arrhythmias?

A cardiologist may insert certain devices during a procedure in the electrophysiology lab.

A permanent pacemaker is a device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. The pacemaker has a pulse generator (which houses a battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to the heart muscle, as well as sense the heart's electrical activity. Pacemakers are mostly used to prevent your heart from beating too slowly.

An implantable cardioverter-defibrillator (ICD) is a sophisticated device used primarily to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again.

There are several ways the ICD can be used to restore normal heart rhythm. These include:

  • Anti-tachycardia pacing (ATP): When the heart beats too fast, a series of small electrical impulses may be delivered to the heart muscle to restore a normal heart rate and rhythm.
  • Cardioversion/defibrillation: When the heart is beating dangerously fast or irregularly, a shock may be delivered to the heart muscle to restore a normal rhythm.
  • Anti-bradycardia pacing: Most ICDs provide backup pacing to prevent too slow of a heart rhythm.

Biventricular (B-V) pacemakers and defibrillators(also called cardiac resynchronization therapy or CRT) are used in people with heart failure who also have evidence of an uncoordinated or out-of-sync contraction of the left ventricle. These devices help to synchronize the contraction of the left ventricle. In addition to the one or two leads used by traditional pacemakers and defibrillators that are placed in the right ventricle and right atrium, bi-ventricular devices utilize an additional lead placed on the back or left side of the left ventricle. To reach this area, the additional lead is typically guided through the coronary sinus, a small vein on the back of the heart.

People with arrhythmias may require heart surgery for any of these reasons:

  • An individual may need heart surgery to treat heart disease that may be causing the arrhythmia, including valve surgery or coronary artery bypass surgery.
  • The Maze and modified Maze procedures are two surgeries used to correct atrial fibrillation not controlled with medications or nonsurgical treatment methods. It’s often used when other types of heart surgery such as valve surgery are planned. In some cases, these procedures can be performed on their own.
  • In some cases, biventricular pacemaker leads may be placed on the heart using minimally invasive or endoscopic techniques.

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