Device Therapy for Patients with Heart Failure (Cleveland Clinic)

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Implantable cardiac defibrillator (ICD)An ICD is an electronic device that constantly monitors the patient's heart rhythm. When the device detects certain abnormal heart rhythms, it delivers energy (a small shock) to the heart muscle to restore a normal heart rhythm. The shock will be brief and may feel uncomfortable, depending on how much energy the ICD delivers to restore a normal heart rhythm.

Studies show that an implantable cardiac defibrillator (ICD) can reduce this risk of death from sudden cardiac arrest. When a life-threatening arrhythmia is detected by the ICD, a high-energy shock is delivered to the heart muscle to restore a normal heart rhythm. The shock that restores your heart rhythm will feel uncomfortable, but it is very brief.

Cardiac resynchronization therapy (also called biventricular pacing)
Cardiac resynchronization therapy (CRT) is designed to treat the delay in heart ventricle contractions that occur in some people with advanced heart failure. The CRT pacing device is implanted and paces the lower chambers of the heart so the right and left ventricle pump together. Small electrical impulses are delivered from the device to the heart muscle through leads (wires) to cause the right and left ventricles to pump together.

Some patients with heart failure may benefit from CRT and an ICD combination therapy. These devices combine biventricular pacing with anti-tachycardia pacing and internal defibrillators to deliver treatment as needed.

CRT improves symptoms of heart failure in about 50 percent of patients who have been treated maximally with medications but still have heart failure symptoms. CRT improves survival, quality of life, heart function, the ability to exercise, and helps decrease hospitalizations in select patients with severe or moderately severe heart failure.

Internal monitoring devices
Some biventricular pacemaker and ICD combination therapies have an internal monitoring device inside so that your doctor or nurse can monitor not only your heart rhythm, but also your heart function. You may be asked to use a telephone to transmit data from your implanted cardiac device to a computer server so that your doctor or nurse can monitor your condition. Device companies have also developed a pacemaker-like device that monitors the pressure in your lower right heart chamber and a blood vessel near the heart. The data stored in the device is sent electronically to a computer server so that your doctor or nurse can review your heart function from a remote location. These devices allow your healthcare team to observe trends or changes in your heart function. Based on this information, your healthcare team may make changes in your medications or reinforce the lifestyle changes you need to make to stay healthy.

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Last Updated: 12/10/2010

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