Cardiac Pacemakers

Pacemakers and implantable cardioverter defibrillators (ICDs) are small devices that deliver energy to the heart through thin, flexible wires called leads. They are implanted beneath the skin, below the collarbone. In the majority of cases we can place the devices with minimally invasive techniques on an outpatient basis (one day or an overnight stay).

The procedure for inserting a pacemaker or ICD is the same.

Pacemakers work "on demand" to treat slow heart rhythms. The small electronic devices are connected to one or more wires (leads) that run to the heart's atrium and/or ventricle via a vein. When the heartbeat is too slow, the pacemaker delivers a small electrical impulse to stimulate the heart to beat.

The pacemaker is implanted during a procedure in which the patient is under local anesthesia. A vein in the upper chest is opened so the pacemaker wires can be advanced into the heart. The wire must touch the heart to carry electrical signals back and forth between the heart and the pacemaker. The wire is then attached to the pacemaker, which is put in a pouch under the skin.

Pacemaker can also help treat bradycardia, a condition characterized by a slow or irregular heart rhythm, usually fewer than 60 beats per minute.

Conduction system pacing (CSP) is a technique of pacing that involves implantation of permanent pacing leads along different sites of the cardiac conduction system and includes His bundle pacing(HBP) and left bundle branch pacing.

Left bundle branch pacing(LBBP) is a novel pacing modality that can bypass the pathological or disease-vulnerable region in the cardiac conduction system, to provide physiological pacing modality for patients.