Heart conditions affect scores of people each year and are the leading cause of death in nearly 18 million individuals annually. However, medical technology also improves and evolves each year, increasing patients’ ability to overcome their health issues and live long, successful lives. Pacemakers and defibrillators are just a few of the modern devices available to combat heart rhythm disorders. In this blog, our team at Heartwell Cardiology in Orlando, FL, explores how these technologies work and the key differences between them.
What Is a Pacemaker?
A pacemaker is a small implantable device that corrects a condition known as bradycardia, or a slow heartbeat. If the heart doesn’t beat fast enough, it is unable to pump the blood supply needed by the body to function properly, and as a result, patients may suffer from fainting, exhaustion, or dizziness, among other symptoms. The pacemaker controls the pace of the heartbeat through electrical impulses, helping it to maintain a steady, predictable rhythm. It is engineered with a pulse generator containing the battery and wires that attach to the heart.
Some common heart conditions that can be improved by a pacemaker include heart block and sick sinus syndrome. With heart block, electrical signals that are supposed to travel with ease between the upper and lower heart chambers are delayed or even blocked entirely. With sick sinus syndrome, also called sinus node dysfunction, the heart’s natural pacemaker ability is compromised. Implanted pacemakers may also help in cases of atrial fibrillation, where the heart has an irregular or rapid rhythm.
Pacemakers Types
There are several types of pacemakers that differ in their design and function. However, all variations are engineered to help the heart maintain a more steady, uniform rhythm. Below are just a few of the most common pacemaker options:
- Single-chamber pacemaker – Connected to either the right atrium or the right ventricle, a single-chamber pacemaker is implanted to correct the effects of bradycardia, or a heartbeat that is too slow.
- Dual-chamber pacemaker – With a dual-chamber pacemaker, two leads are connected to the right atrium and right ventricle. The device works to improve the coordination between these two heart areas, leading to a more natural and steady heart rhythm.
- Biventricular pacemaker – With this version of the pacemaker, also called a cardiac resynchronization therapy (CRT) device, leads are placed in both ventricles to improve coordination and make sure the heart can pump the blood the body needs to function optimally.
- Leadless pacemaker – A leadless pacemaker is a one-piece device placed in the heart’s inner wall to combat a slow heart rate. It is inserted through a catheter-based mechanism and is known to minimize complications related to larger devices.
What Are Defibrillators?
Defibrillators, also called ICDs or implantable cardioverter-defibrillators, are life-saving devices that treat heart arrhythmias like ventricular tachycardia or fibrillation. These disorders make the heart beat too fast, which can trigger sudden cardiac arrest. In addition to monitoring the heart’s rhythm, a defibrillator can detect abnormal patterns and deliver a shock that restores a regular, predictable heartbeat. While pacemakers address slow heart rhythms, defibrillators calm heartbeats that are dangerously rapid, preventing fatalities.
Defibrillators Types
Like pacemakers, defibrillators come in different versions, allowing for treatment customization. The main defibrillator types include the following:
- Implantable cardioverter-defibrillator (ICD) – Inserted under the skin near the collarbone, an ICD connects to the heart via leads, continuously monitoring the heart’s rhythms to prevent arrest and delivering shocks when arrhythmias present a threat to the system. ICDs often have the capacity to function as pacemakers when needed. Each device can be controlled by a healthcare professional through specific settings that correspond to the patient’s needs.
- Subcutaneous ICD – This is a newer device type implanted beneath the skin. Instead of having the leads inside the heart, they run along the rib cage. A subcutaneous ICD is best suited for patients at a lower risk for bradycardia but who still need defibrillation.
- Wearable cardioverter-defibrillator (WCD) – This device is worn externally around the chest rather than implanted. Healthcare providers may select this option for patients at risk of sudden cardiac arrest who are not candidates for ICDs. Like other types of defibrillators, a WCD will closely monitor heart rhythms and provide shocks when required. The device is usually prescribed after a heart attack or while the patient waits to be implanted with an ICD.
Determining Candidacy for a Pacemaker or Defibrillator
Through careful medical evaluation, a doctor will assign the right type of device that fits the patient’s needs and unique concerns. The diagnostic process will determine whether a patient needs a pacemaker or defibrillator. Tests such as electrocardiograms (ECG), Holter monitoring, and stress tests are typically used to assess the patient’s heart health. They can pinpoint heart rhythm abnormalities, guiding healthcare professionals to select the best treatment plan.
- Electrocardiograms measure the heart’s electrical activity, diagnosing irregular rhythms.
- Holter monitoring observes the patient’s heart rhythms over a 24-48 hour period, which can help detect arrhythmias that don’t show up during standard ECGs.
- Stress tests measure the heart’s response to physical exertion and can detect concerns like coronary artery disease that may be contributing to arrhythmias.
Pacemaker Candidates
Pacemakers are recommended for individuals struggling with bradycardia or conditions involving a heart that beats too slowly. These patients may have the following conditions:
- Heart block – The electrical signals in the patient’s heart are delayed.
- Sick sinus syndrome – The heart’s natural internal pacemaker doesn’t function optimally.
- Atrial fibrillation – The beat within the upper and lower chambers of the heart is out of sync.
Defibrillator Candidates
Defibrillators are recommended for those at risk of sudden cardiac arrest. Patients needing defibrillators may suffer from the following conditions:
- Ventricular tachycardia – The beat in the lower chambers of the heart pounds too rapidly.
- Cardiomyopathy – A disease of the heart muscle causes dangerous arrhythmias.
- Prior heart attack – Heart attack survivors may be at higher risk of sudden cardiac arrest.
Conclusion – Your Healthcare Provider Can Help Choose the Best Device
Working with a trusted, experienced heart health specialist is the best way to ensure your longevity and well-being. Your heart doctor will select a pacemaker or defibrillator based on your symptoms and diagnostic tests. Pacemakers restore proper heart function for those with bradycardia, poor blood circulation, or a slow heart rhythm, whereas those with a dangerously fast heart rhythm who are at risk of sudden cardiac arrest will be treated with a defibrillator. Understanding the different device variations and how they can help you to thrive is part of your cardiologist’s job and something they have trained for throughout their careers.
Want to Learn More About Maintaining Optimal Heart Health? Contact Heartwell Cardiology in Orlando, FL, Today!
Contact us at Heartwell Cardiology today to learn more about our personalized heart health solutions and diagnostic testing. We tailor each treatment to your unique needs and concerns, providing concierge care and access to today’s most cutting-edge technologies and devices. While facing heart problems can be daunting, our compassionate, dedicated providers make your medical journey stress-free and seamless. We look forward to meeting with you for a private consultation in Orlando, FL.