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An Automatic Defibrillator is a device which is implanted in the patient’s upper chest. An electrode wire is inserted through the vein into the chamber of the right ventricle. It delivers an electrical shock to restore a patient’s heart rhythm during cardiac arrest.

The device is used for people who have had demonstration of serious life–threatening Cardiac Arrhythmias (Ventricular Tachycardia or Fibrillation), those who have had previous heart attacks, heart damage and heart surgery, including Bypass and Valve replacements.

The insertion of an Automatic Defibrillator is done in the operating room and currently is done under general Anesthesia; however, some cases may be selected for local Anesthesia with intravenous sedation. The surgeon will make an incision below the collarbone on the left side and fashion a pulse generator pocket. At that time the Electrophysiologist will insert an electrode pacing lead, which has the ability to record signals from the heart, as well as to deliver electrical shocks between the lead terminals and the can of the Automatic Defibrillator pulse generator.

During the operation, the patient will have Ventricular fibrillation triggered and the device will be tested to show that it can safely convert Ventricular fibrillation to Sinus rhythm and sense and react appropriately and quickly. During the test, the patient will have external rescue pads placed on his chest in case an external shock is necessary to revive heart rhythms. During this study, the patient’s oxygenation, and blood pressure, and vital signs are all measured continuously to monitor him during the procedure. Following the procedure, the patient will recover in the hospital, usually for a period of 24 to 48 hours. They will receive Intravenous Antibiotics and X–rays and be monitored on the telemetry floor.

Permanent Pacemakers
A Pacemaker restores healthy heart rhythms for people whose hearts are beating too slowly or irregularly. Pacemakers can speed up slow heart rhythms and smooth irregular ones. A Pacemaker system has two main parts: a small metal can called a Pulse generator and an insulated wire called a Lead. There are different types of Pacemakers and different programming modes. Your Cardiologist will decide the one most suitable for you and your condition.

Pulse generator is an electrical device that houses a battery, electronic circuitry and connection outlet for the lead. A pulse generator produces an electrical signal, and the lead carries the electrical signal to the heart, stimulating it to beat. It is implanted under the skin of the upper chest. The operation takes about one hour and may be performed using local anesthesia. The Pacemaker can be adjusted to provide the best type of pacing for the patient’s condition. These adjustments can be made with a Computerized programming device placed over the skin above the Pacemaker.

Patients should take their pulse daily to keep a record of their Pacemaker’s rate. Pacemakers are now designed to last several years.

Radio Frequency Abilation
In the past several years, Radio Frequency Abilation (RFA) has become the treatment of choice for specific rhythm disturbances. High frequency radio waves use thermal heat to burn and eliminate the precise location in the heart from which an arrhythmia originates.