Cardiac devices for patient with heart failure

Overview

Cardiac devices are utilized to maintain the normal rhythm of your heartbeats. Devices come in a variety of types. If you are diagnosed with heart failure and have a reduced ejection fraction (HF-rEF), your doctor will assess your condition and discuss with you the most suitable device to address your specific requirements. If the patient has any questions or concerns about the type of operation, it is important to discuss them with the healthcare provider.

Types

Cardiac devices, such as implantable cardiac defibrillators (ICDs), biventricular pacemakers, and ventricular assist device (VAD), are made to help people with heart failure and certain heart rhythm abnormalities manage or keep a watch on their irregular heartbeats.

• Implantable Cardiac Defibrillator (ICD): An electronic device inserted inside the body is called an implantable cardiac defibrillator (ICD). An ICD monitors the cardiac rhythm continuously and, in the event that the rhythm deviates from normal (arrhythmia), it sends a shock to the heart muscle. If a shock is required, it can be extremely uncomfortable, but it fades quickly. Instead of using a shock, some ICDs employ a pacing system. This kind of ICD resets the cardiac muscle to its regular rhythm by sending a quick impulse. Sudden cardiac arrest (SCA) risk can be decreased with the use of an ICD.
• Biventricular pacing: The ventricles contract normally with the assistance of biventricular pacemaker, also known as cardiac resynchronization therapy(CRT). Some HF-rEF patients may benefit from this treatment.
  An external pacemaker is implanted in the body as part of CRT treatment. The pacemaker has three wires, or leads, that stimulate the heart muscle with tiny electrical impulses to maintain the ventricles pumping in unison. These impulses does not cause any pain.
  An ICD and CRT are combined in a device called a CRT-D. It maintains the ventricles’ coordinated beating. The CRT-D shocks them back into sync if ventricular tachycardia or fibrillation causes them to go out of sync. When taking medication and receiving CRT, either with or without an ICD, about 75% of patients report improvement in their symptoms.
  Cardiac resynchronization therapy can enhance your chances of survival, enhance your quality of life, improve heart function, boost exercise capacity, and reduce the likelihood of hospitalization.
• Ventricular assist device (VAD): An implanted pump called a ventricular assist device (VAD) helps the heart’s weaker ventricle pump blood throughout the body. When a patient has advanced HF-rEF, a VAD may be utilized as a last resort or as a “bridge to heart transplant,” meaning the device is implanted until the patient is able to receive a heart transplant.

Outcome

Following a cardiac device implantation procedure, many patients resume their daily routines. However, to effectively manage these cardiac devices, some lifestyle adjustments may be necessary. Healthcare providers offer guidance and support to help patients make these necessary adjustments and address heart-related concerns.

Healthcare professionals can assess whether a patient is fit to return to their exercise regimen. They may recommend avoiding contact sports like football, as these activities pose a risk of the device coming into contact with the implant site, potentially causing damage to the device or its leads. The patient’s ability to engage in physical activity can also be influenced by their specific cardiac condition, and any additional restrictions should be discussed in consultation with their healthcare provider.

It’s important to note that certain dental, medical, or imaging procedures can impact the functionality of the implanted cardiac device. While most modern pacemakers and ICDs are compatible with many MRI scans, there are exceptions due to strong magnetic fields that can interfere with the device’s operation. The decision on whether it’s safe to undergo an MRI scan should be made by a healthcare provider after careful evaluation.