Pacemakers & Defibrillators
There are a variety of devices your physician may prescribe to help your heart function and extend your life when you have dilated cardiomyopathy (DCM). Think of these as your heart’s “electrical” support system.
Types of Devices
There are two major categories of devices used to manage DCM: pacemakers and defibrillators.
Standard Pacemakers
These are used to regulate your heart rhythm and ensure it doesn’t beat too slowly.
Biventricular Pacemakers (CRT)
This specialized device treats electrical abnormalities (like Left Bundle Branch Block – “LBBB”) common in DCM. By coordinating the heart’s timing, it can improve your Ejection Fraction (EF) and survival. This is called Cardiac Resynchronization Therapy.
Note: Many CRT devices also include a defibrillator; such devices are called CRT-Ds.
Defibrillators (ICD)
These monitor your heart 24/7 for life-threatening rhythms. If a dangerous rhythm is detected, the ICD can pace the heart back to normal or deliver a life-saving shock. (Some patients describe this as a sudden, sharp ‘thump’ or ‘kick’ in the chest; while startling, it is the device doing its job to save your life.) Sometimes, people are not aware that the defibrillator may be performing functions.
How They Work
Both device categories have two main parts:
- The Pulse Generator: The “battery” part that contains the computer.
- The Leads: Small electrical wires that deliver signals from the battery to your heart muscle.
The Implantation Process
Implantation is a common procedure usually performed under local anesthesia with sedation.
- The Device: The battery is typically placed under the skin and fat near your collarbone.
- The Leads: Wires are guided through blood vessels into specific locations in your heart and connected to the pulse generator.
Battery Life & Replacement
Batteries are designed to last for years, though the timeframe depends on the device type and how often it’s used:
- Standard Pacemakers: Often last 10 years or longer.
- CRT Devices: Typically last approximately 4 years (sometimes less) because they are designed to operate continuously.
- Replacement: When a battery is low, a surgeon replaces the pulse generator (the battery component) and reconnects it to your existing leads.
Lead Failure: Rarely, the leads may fail or need to be replaced. If this occurs, your physician can explain what caused it and what options are available.
Living With Your Device
It is important to follow your doctor’s instructions after receiving a pacemaker or defibrillator.
Recovery & Activity
- Immediate Recovery: Right after surgery, you will likely need to restrict arm movement on the side of the implant. This allows the leads to bond properly to your heart.
- Driving: Doctors may recommend a short break from driving to avoid pressure on the incision site.
- Long-Term: Once your doctor clears you, you can resume a normal, active life. Your care team is your best resource for determining which specific activities are safe for you.
Remote Monitoring
Most devices come with a Home Monitor. This device sits by your bed and automatically sends data about your heart and the battery health to your doctor (usually every three months).
Tip: Ask your doctor if you should manually send a transmission if you experience a specific symptom, like a dizzy spell.
Travel & Safety
Traveling with a device is generally safe with proper preparation. It is always a good idea to ask your device nurse or cardiologist if they advise any specific travel precautions for you. Your pacemaker nurse is an excellent source for you regarding travel issues.
- Carry your device ID card at all times. You should have received this card from your device nurse or cardiologist at the time of implant. It contains important information about your specific device and is especially helpful when traveling.
- Air travel: Let the TSA agent know you have a pacemaker or defibrillator before going through security. You may be asked to show your device ID card.
- Check before you go: Ask your device nurse or cardiologist if they recommend any special travel precautions based on your device or health status.
Know what’s safe: Educational videos are available that explain airport metal detectors and the safe use of magnets around pacemakers.
Emotional Support
It is normal to feel a range of emotions after getting a device. Some patients feel a sense of relief, while others feel anxious about “shocks” or having a foreign object in their body.
- Connection: Joining a support group can help you hear from others who have gone through the same experience.
- End-of-Life Care: If you enter hospice or end-of-life care, you may choose to have the defibrillator function “turned off” to avoid uncomfortable shocks. Discuss this with your family and physician early on.
You may want to join a support group and discuss any concerns with others. There are many groups available in person and online.
To join device-related Facebook support groups, please visit:
Living with a Medtronic Pacemaker, ICD, or CRT Device
Other Support Tools
Wearable Devices & Medic Alerts
- Smartwatches: Many patients use apps to monitor their heart rate. Research which ones may be helpful for your specific needs.
- Medic Alert Jewelry: Bracelets or necklaces can inform emergency responders of your medical condition and the device. This is a matter of personal preference.
Advanced Support: VADs
For advanced heart failure, a Ventricular Assist Device (VAD) may be used. This mechanical pump helps your heart move blood throughout your body. It is often used as a “bridge” for those waiting for a heart transplant or as a long-term treatment for those not eligible for a transplant.
Questions?
Your care team is your best resource for questions about devices, activity, and long-term planning. Never hesitate to ask what applies specifically to you.