A cardiac device check refers to the assessment and evaluation of implanted cardiac devices, such as implantable loop recorders (ILRs), pacemakers (PPMs), implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) devices. These checks are typically performed by Cardiac Physiologists, with a specialist interest in cardiac devices.
A cardiac device check refers to the assessment and evaluation of implanted cardiac devices, such as implantable loop recorders (ILRs), pacemakers (PPMs), implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) devices.
These checks are typically performed by Cardiac Physiologists, with a specialist interest in cardiac devices. These devices should be checked regularly – typically on a 12-monthly basis, however this can be different depending on individual circumstances.
Implantable Loop Recorder (ILR)
ILRs are tiny ECG recorders, which are implanted underneath the skin around the chest wall area. The device has sensors on there, which can continuously monitor the ECG, helping detect and diagnose intermittent arrhythmias, which cannot be recorded via other tests (i.e. 12-Lead ECG or Holter monitors).
Patients who have occasional palpitiations, dizzy spells or loss of consciousness or even a Transient Ischaemic Attack (TIA) without any identifiable cause may benefit from an ILR.
The device is programmed with certain parameters, which will automatically record any rhythm which meets these parameters, as well as having a ‘symptom activator’ which allows the patient to let us know when they are symptomatic, so we can identify if their ECG is affected or not.
Permanent Pacemaker (PPM)
A pacemaker is an electrical device, comprised of a generator that sits under the skin, connected to one or two leads, which pass through a vein and go directly into the heart, which results in the top and/or bottom chambers of the heart to be sensed or paced.
A Leadless pacemaker is a small device which is implanted directly into the bottom chamber of the heart, the ventricle, to stimulate it.
Pacemakers are implanted in order to treat abnormal rhythms that can cause the heart to beat too slowly, or miss beats. PPMs result in symptom improvement such as shortness of breath and dizziness, as well as an improvement in life expectancy for patients with conduction issues.
Implantable Cardioverter Defibrillator (ICD)
An ICD is a device that can detect and treat life-threatening arrhythmias, such as Ventricular Tachycardia or Ventricular Fibrillation. The device can treat these arrhythmias by rapid pacing (delivering a burst of antitachycardia pacing) or by delivering an electric shock to the heart, stunning the heart to restore normal rhythm (defibrillation). These devices can also provide the same function a pacemaker, by preventing slow heart rates.There are two main types of ICDs:
Transvenous ICD – comprised of a generator that sits under the skin, connected to one or two leads, which pass through a vein and go directly into the heart, which results in the bottom (and top if required) chambers of the heart to be sensed or paced, with the lead in the bottom chamber able to deliver the therapies
Subcutaneous ICD – comprised of a generator that sits on the side of the chest, under the left arm, with a lead buried under the chest, going from the device to the middle of the chest (not in the heart)
ICDs can improve the life expectancy in patients who have suffered a dangerous heart rhythm (secondary prevention) and in those who are at risk of a dangerous arrhythmia but have not yet had it (primary prevention).
Cardiac Resynchronisation Therapy (CRT)
A CRT device is implanted to improve the coordination of the heart’s contractions, making it beat more efficiently. This device is quite similar to a pacemaker, however can have 2 or 3 leads; as the extra lead helps both of the bottom chambers pump simultaneously. This ultimately leads to an improvement in heart function and reduces the symptoms of heart failure over time.
This device can either be in the form of a pacemaker, or a defibrillator (called CRT-P and CRT-D respectively).
During a cardiac device check, the Cardiac Physiologist will interrogate your device using a specific programmer for the relevant device manufacturer. This will allow the Cardiac Physiologist to assess the functionality of the device, ensuring the device is programmed in the most optimal way for your needs and cardiac history.
These are the main aspects that will be analysed during the device check:
The Cardiac Physiologists then type a report and send it to your referring Cardiologist, who will discuss the findings in further detail during the consultation.
A Pacemaker is a small electrical device that sends electrical pulses to your heart to keep it beating regularly.
The Pacemaker will be fitted during a small surgical procedure by a Consultant Cardiologist who will place it under the skin near the collarbone on the left side of the chest. The Pacemaker Box links to a wire that is guided through a blood vessel to the heart.
Our Heart Health specialists at OneWelbeck in London are leaders in their field. They are equipped with the latest diagnostic medical technology at custom-built, day-case facilities to investigate any symptoms and ensure you receive the best available care.