Search

Pacemaker

844

Pacemakers are devices that are implanted into the body, just below the collarbone, to take over the job of the heart’s own electrical system and prevent slow heart rates. Although they weigh only an ounce and are the size of a large wristwatch face, a pacemaker contains a computer with memory and electrical circuits, a powerful battery (generator), and special wires called “leads.” The generator creates electrical impulses that are carried by the leads to the heart muscle, signaling it to pump.

Defibrillation, or shock, can be the only way to stop certain heart arrhythmias, or irregular heartbeats, before they kill. If the heart beats too quickly, the chambers, or ventricles, will not have enough time to fill with blood and pump blood to the rest of the body, which can cause death. For people at high risk for the deadliest forms of arrhythmias – called ventricular tachycardia and ventricu­lar fibrillation – an internal “shocking” device may be the best protection against sudden cardiac arrest (SCA).

An update to this document was published in 2017 and is available at this link.  

May 13, 2009 — An international team of device and lead management experts from North America and Europe wrote this 2009 consensus document on the management of leads in patients with cardiovascular implantable electronic devices (CIEDs). Central to this effort was a focus on transvenous lead extraction, including standards for training and for the evaluation of new tools and techniques.

May 5, 2011 — Developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA) and the Society of Thoracic Surgeons (STS), a diverse panel of experts in pacemaker and defibrillator management focused on medical procedures that might interfere with Cardiovascular Implantable Electronic Devices (CIEDs) function.

May 9, 2014 - This expert consensus statement was written by experts and developed in partnership with and endorsed by the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA); and in collaboration with and endorsed by the Heart Failure Society of America (HFSA) and the Society of Thoracic Surgeons (STS).  Endorsed by the European Heart Rhythm Association (EHRA), the Asia Pacific Heart Rhythm Society (APHRS) and the Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE)-Latin American Society of Cardiac Pacing and Electrophysiology.

June 26, 2012 — The statement is the first of its kind to specifically address pacemaker device and mode selection, expanding upon the ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities.

The new statement provides a state-of-the-art review of the field and reports consensus recommendations on pacemaker device and mode selection. It is a guide to facilitate the appropriate use of single vs. dual-chamber devices for patients who already meet guidelines for pacemaker implantation.

May 13, 2015 - The current document is developed from the foundations established by the 2008 HRS Consensus Statement as well as the 2012 International Society for Holter and Noninvasive Electrocardiography and European Heart Rhythm Association’s Expert Consensus Statement on Remote Monitoring of CIEDs.  The goals of follow-up, definition of hardware, and personnel remain the same and will not be covered in this document except where evolution of remote technologies and responsibilities has occurred. The current document provides new recommendations based on data published since 2008, endorsing the need to maintain consistent follow-up, and outlining the limitations of strictly in-person methods.

The topic covered by this document includes the monitoring of CIEDs with a description of the technology, indications for use, personnel involved in monitoring and the frequency and types of monitoring events. Also covered are issues in regard to data management, regulatory environments, reimbursement and ethical considerations in respect to device inactivation.

This document has been retired and replaced by 2015 "HRS Expert Consensus Statement on Remote Interrogation and Monitoring for Cardiovascular Electronic Implantable Devices."