2 Cardiac Devices Hospitals In Ann Arbor, Michigan

Cardiac Devices (click for worldwide facilities list): Every day, patients' lives are extended by pacemakers and other implantable cardiac devices that enable faltering hearts. Abnormal heart rhythms can be treated by implantation of a pacemaker or of an ICD (implantable cardioverter defibrillator).

Pacemakers:

A pacemaker sends electrical impulses to the heart muscle to maintain a suitable heart rate and rhythm and may also be used to treat fainting spells (syncope), congestive heart failure, and hypertrophic cardiomyopathy.

Most pacemakers are implanted to treat bradycardia, which can be caused by conduction disorders such as heart block or by sinoatrial (SA) node dysfunction. Pacemakers are classified based on how they pace the heart, which chambers of the heart they pace, what they do when they sense a dysrhythmia, how many leads they use, and where those leads are placed. Most are demand pacemakers, which means they provide electrical signals only when they sense that the heartbeat has dropped below a preset rate.

There are single chamber, dual chamber, and biventricular pacemakers. Single-chamber devices have one lead that paces the right atrium or right ventricle; dual-chamber devices have separate leads that connect to both the right atrium and ventricle. A biventricular pacemaker has three leads: one for each ventricle and one for the right atrium.

Cardiac resynchronization therapy (CRT), or biventricular pacing, is used when the right and left ventricles do not pump together, which causes the left ventricle to be unable to pump enough blood throughout the body. It uses a biventricular pacemaker, which works by sending small electrical impulses through the leads.

ICDs:

An ICD is an implanted device. The ICD constantly monitors heart rate and rhythm. An ICD is about the size of a pager. Like a pacemaker, it uses leads to monitor the heart's rhythm and deliver electrical pulses as needed. Most ICDs can record episodes of dysrhythmia for later evaluation, and some can be programmed to serve as pacemakers, sparing the patient the shock from an ICD.

When an ICD detects a very fast, abnormal heart rhythm, it can deliver high-energy electrical pulses (shocks) to restore the heart's normal rhythm. Just Like pacemakers, there are single chamber, dual chamber and biventricular ICD’s. The left ventricular assist device (LVAD or VAD) is a kind of mechanical heart, placed inside a person's chest, where it helps the heart do its job. It is not an artificial heart that replaces it. A person whose heart needs a rest after open-heart surgery or a person waiting for a heart transplant may benefit from it, and it may also be used to allow weakened hearts to recover.

New cardiac devices are being developed. One such device is an implantable hemodynamic monitor (IHM). The device uses a lead placed in the right ventricle to continuously measure intracardiac pressure, body temperature, physical activity, and heart rate. he IHM stores these measurements, and a patient uses a remote monitor to intermittently transmit the data over a phone line to a secure Web site that the physician can access. Using an IHM may allow clinicians to monitor patients more closely and intervene before a patient develops symptoms of worsening heart failure.

The surgery and post operative care are similar for all patients regardless of which type of implantable cardiac device they receive. Typically, patients undergo same-day surgery or are admitted for an overnight stay. They usually receive local anesthesia and undergo moderate sedation.

VADs:

Ventricular assist devices support patients with intractable congestive heart failure. Ventricular assist devices are utilized for three reason:

In patients awaiting cardiac transplant, ventricular assist devices can be implanted to support the failing heart and serve as a bridge to transplant.

In some patients with reversible forms of cardiac failure, a ventricular assist device can be implanted with the hope that it will allow the heart to recover, and later the assist device can be removed. This indication is known as a bridge to recovery.

In selected patients who are not good candidates for cardiac transplantation because of other medical complications, ventricular assist devices can be implanted which are intended to support circulation over a period of years. This use is known as destination therapy. The new generation of pumps is designed for chronic, out-of-hospital use so that most patients can return home after the VAD is implanted.

Heart pumps used to support the left ventricle alone are known as LVADs (left ventricular assist devices) and those used to support both the right and left ventricle are known as bi-vads (biventricular assist devices). Sometimes only the right ventrical is supported (RVAD).

http://www.mayoclinic.org/heart-transplant/vad.html

http://rn.modernmedicine.com/rnweb/article/articleDetail.jsp?id=339912

Also known as: Pacemakers, ICDs, IHM, VADs