Implantable Cardiac Rhythm Devices

Implantable cardiac rhythm devices, also known as cardiac implantable electronic devices (CIEDs), are medical devices that are implanted into the body to monitor and regulate the heart’s electrical activity.

There are several types of CIEDs, including:

  • Pacemakers
  • Implantable cardioverter-defibrillators (ICDs)
  • Cardiac resynchronization therapy (CRT) devices
  • Implantable loop recorders (ILRs)
Fig 79 cardiac devices
CIEDs are typically implanted during a minimally invasive surgical procedure and are connected to leads (thin wires) that are threaded through veins and into the heart. The devices are powered by batteries and can last for several years before needing to be replaced.
CIEDs are an important treatment option for patients with a variety of heart conditions, including bradycardia (slow heart rate), tachycardia (fast heart rate), heart failure, and certain genetic heart conditions. However, the decision to implant a CIED should be made on an individual basis after a thorough evaluation by an electrophysiologist.
While many doctors claim that they can implant and manage pacemakers and ICDs, it is vital that only an experienced doctor with specialized training in electrophysiology should deal with implantable cardiac devices. Electrophysiologists undergo extensive and dedicated training in the implant and management of these devices and are, therefore uniquely qualified and have the knowledge and expertise to diagnose and treat patients with these devices.
Here are some reasons why an electrophysiologist, in preference to a general cardiologist, should manage implantable cardiac devices:

Here are some reasons why an electrophysiologist, in preference to a general cardiologist, should manage implantable cardiac devices:

Specialised knowledge in indications for implant

Electrophysiologists are trained in heart rhythm disorders. The can advise when a cardiac device implant is needed or can be avoided

Expertise in implantation and programming

Electrophysiologists have specialized training and experience in implanting and managing cardiac devices. Their experience cannot be compared to people who occasionally implant devices. They have a deep understanding of the complex technology and programming required to optimize the functioning of these devices. They can choose the device and leads that would be the best fit for the specific needs of the patient.

Diagnosis and monitoring of arrhythmias

Electrophysiologists are experts in diagnosing and monitoring arrhythmias, which are often the reason for implanting cardiac devices. They can assess the effectiveness of the device and adjust the programming to optimize therapy.

Managing complications

Implantable cardiac devices can sometimes cause complications, such as infections, lead fractures, or device malfunction. Electrophysiologists are equipped to identify and manage these complications to minimize risks to the patient.

If a pacemaker or an ICD has been recommended, it’s important to discuss the case with a specifically physician trained in the management of heart rhythm disorders to have the best outcome.