What Should Seniors Know About Pacemakers and Implantable Devices?
Cardiac implantable devices including pacemakers and defibrillators help millions of seniors live longer, more active lives. Understanding these devices helps seniors make informed decisions and live safely with their implants.
Types of Cardiac Devices
Pacemakers monitor heart rhythm and deliver electrical impulses when the heart beats too slowly. They treat bradycardia, abnormally slow heart rates that cause fatigue, dizziness, and fainting. Pacemakers ensure the heart maintains adequate rate to meet the body’s needs.
Implantable cardioverter-defibrillators, called ICDs, monitor for dangerous fast rhythms and deliver shocks to restore normal rhythm. They protect against sudden cardiac death from ventricular arrhythmias. ICDs also function as pacemakers when needed.
Cardiac resynchronization therapy devices coordinate the heart’s chambers to pump more efficiently in certain heart failure patients. These may be combined with pacemaker or ICD function. They improve symptoms and survival in appropriate candidates.
The Implantation Procedure
Device implantation is typically performed under local anesthesia with sedation. A small incision below the collarbone creates a pocket for the device. Leads are threaded through veins to the heart. The procedure takes one to three hours, with most patients going home the same day or next morning.
Recovery involves limiting arm movement on the implant side for several weeks while leads secure in place. Most people return to normal activities within a few weeks. Lifting restrictions gradually ease. Driving restrictions apply for the first week or longer for ICD patients.
Living with a Device
Most daily activities continue normally with implanted devices. Devices are designed for long-term reliability. Modern devices last 7 to 15 years before battery replacement is needed, a simpler procedure than initial implantation.
Electromagnetic interference concerns are less significant with modern devices but some precautions remain. Avoid placing cell phones directly over the device. Pass quickly through store security systems. Inform medical personnel about your device before MRI scans or certain procedures.
Carry your device identification card at all times. The card contains essential information for medical personnel. Medical alert identification is also recommended.
Monitoring and Follow-Up
Regular follow-up monitors device function and battery life. Remote monitoring allows many checks from home, reducing office visits. The device transmits data via phone or internet to the monitoring center, which alerts the care team to any concerns.
In-person visits occur periodically for comprehensive device checks. Programming can be adjusted to optimize function. Battery status determines when replacement planning should begin.
When Devices Fire
ICD shocks for dangerous rhythms are lifesaving but can be startling and uncomfortable. Patients describe sensations ranging from a thump to a kick in the chest. A single appropriate shock is not an emergency, but notify your care team.
Multiple shocks or shocks when feeling well may indicate device malfunction or need for adjustment. Seek immediate medical attention for multiple shocks, shocks with severe symptoms, or visible device pocket problems.
End-of-Life Considerations
As life nears its end, device function can be reconsidered. ICD shocks may not align with comfort goals in terminal illness. Deactivation of shock function is ethical and does not hasten death. Discussing preferences in advance enables care aligned with values.
Getting Cardiac Device Information
All Seniors Foundation supports seniors with cardiac conditions including those with implanted devices. Understanding your device enables confident living. Contact us if you have questions about living with cardiac devices.
