IMPLANTABLE DEVICES

Some children with cardiomyopathy develop arrhythmia, an abnormal heart rate that is too quick, slow, or irregular. With cardiomyopathy, this occurs when the electrical impulses that coordinate a person’s heartbeat do not work properly because of swelling or scarring of the heart muscle.

Arrhythmia can cause fatigue, shortness of breath, or fainting. If left untreated, it can lead to ventricular fibrillation and a cardiac arrest. An automatic implantable cardioverter defibrillator (AICD) or biventricular pacemaker may be recommended to relieve symptoms or protect against sudden cardiac death. Both are small battery-operated devices — composed of a generator and a computer chip — that are inserted under the skin of the chest or abdomen with electrical wires (leads) placed directly on the heart or threaded through veins into the heart.

Automatic Implantable Cardioverter Defibrillator

An implantable cardioverter defibrillator (ICD) is used to monitor an irregular heart rhythm and protect patients from life-threatening arrhythmia. When an ICD detects an abnormal heartbeat in the lower heart chambers (ventricles), it emits either a low-energy pulse or high energy shock. ICDs are prescribed for patients who are at higher risk for sudden death. Risk factors may include:

  • Episodes of fainting 
  • Resuscitation from a cardiac arrest
  • Life-threatening arrhythmias
  • Family history of sudden death
  • Thick heart muscle or poor heart function

Pacemakers and Biventricular Pacemakers

To treat less dangerous heart rhythms in the upper heart chambers (atria), a pacemaker is implanted to monitor the heart’s electrical activity and regulate the heart’s contractions. Low energy electrical pulses prompt the heart to beat at a normal rate.

People who have heart failure may undergo cardiac resynchronization therapy (CRT) with a special device. The CRT device, also known as a biventricular pacemaker, regulates the contraction of both lower chambers of the heart (ventricles), which allows them to work together to pump blood out of the heart better.

Procedure

Implanting a pacemaker or ICD requires a short hospital stay. Once inserted, the electrical settings and parts need to be checked regularly by an electrophysiologist. The battery and the patient's heart rhythm are checked by placing a monitor over the skin above the device generator.