Pacemaker and ICD Devices

If you have certain cardiovascular problems, such as an irregular or slow heartbeat (arrhythmia) or heart failure, your heart may need support. Small devices placed inside your chest can help your heart beat normally or pump more effectively.

These devices, called pacemakers and implantable cardioverter defibrillators (ICDs), are available from the University of Iowa Heart and Vascular Center’s expert electrophysiologists.

When combined with other treatments like prescription medicine, pacemakers and ICDs can greatly improve symptoms, including:

  • Dizziness
  • Fainting
  • Fatigue
  • Lightheadedness
  • Shortness of breath

No matter what type of device you need, our goal is to help you feel better and live longer.

Our approach to pacemaker and ICD care

If you need a pacemaker or ICD, you should have confidence in the team that’s placing and monitoring your device.

People across Iowa trust us to implant and manage their device because:

  • We have extensive experience: Our electrophysiologists perform hundreds of pacemaker and ICD implants every year. They know how to perform these procedures safely and successfully.
  • We’ll monitor your device remotely: We use technology that lets us keep an eye on your pacemaker or ICD function while you go about your day. Your device automatically alerts us if you experience unusual changes in heart rhythm. Remote monitoring reduces the number of in-person device checks you’ll need throughout the year. It also allows us to quickly evaluate your heart at the first sign of abnormal symptoms.
  • Our team is specially trained: Your device will only be checked by providers with extensive training in electrophysiology. Because we’re deeply familiar with these devices, we’re qualified to troubleshoot problems and answer any questions you may have.
  • We offer cardiac resynchronization therapy (CRT): We can provide innovative biventricular pacemakers and ICDs (also known as CRT devices) to patients who have arrhythmia along with certain types of heart failure. These devices can help restore the heart’s pumping ability, even among patients who might otherwise need a heart transplant.

We also offer any other treatments you might need to manage your condition. These include procedures such as cardiac ablation and left ventricular assist device (LVAD) placement.

Pacemakers and ICDs available from the UI Heart and Vascular Center

The type of device you’ll need depends on several factors. These include the type of arrhythmia you have and whether you also have heart failure. It also depends on whether you’ve had, or are at risk for, sudden cardiac arrest (your heart abruptly stops beating).

The UI Heart and Vascular Center offers the most up-to-date devices available.

Types of pacemakers we offer

Pacemakers treat heart rhythms that are dangerously slow, also known as bradycardias.

The device contains sensors that can tell when your heart rate drops too low. When this happens, the pacemaker’s pulse generator sends an electrical impulse into your heart.

With most pacemakers, these impulses travel through insulated wires (leads) that connect the device to one or more chambers in your heart. When the impulses reach your heart, they restore your heart rate back to normal.

We offer four types of pacemakers:

  • Single-chamber pacemaker: This type of pacemaker has one lead. It sends electrical impulses into one of your heart’s chambers, usually the right ventricle. This is sometimes referred to as single-chamber pacing.
  • Dual-chamber pacemaker: This device has two leads that connect to both chambers on the right side of your heart—the right atrium and right ventricle. You may need this type of pacemaker if your right atrium and right ventricle aren’t pumping in sync.
  • Biventricular pacemaker: This device, which treats arrhythmia and some types of heart failure at the same time, has three leads. It’s also known as cardiac resynchronization therapy (CRT), or a CRT-P device. It sends electrical impulses into your right atrium and both of your heart’s bottom chambers— the left and right ventricles. Because this helps the bottom chambers work together, your heart pumps blood more efficiently. This helps reduce heart failure symptoms and may even reverse heart muscle weakness (cardiomyopathy).
  • Leadless pacemaker: A leadless pacemaker doesn’t have any leads. It’s implanted directly into your heart’s right ventricle. You may be eligible for this tiny pacemaker if you have a slow heart rate and only need single-chamber pacing.

Types of ICDs we offer

Implantable cardioverter defibrillators treat heart rhythms that are dangerously fast (tachycardias). An ICD can also help prevent sudden cardiac arrest—a life-threatening complication associated with certain types of tachycardia.

When your heart beats too rapidly, the device sends an electrical impulse into your heart to slow it down. Depending on the type of arrhythmia you have, this impulse may be mild, meaning you probably don’t feel it, or high-energy, a noticeable shock to the chest.

We offer three types of ICDs:

  • Traditional (transvenous) ICD: The components that make up a traditional ICD are similar to those of a pacemaker. It contains a pulse generator that produces the electrical impulses and one or two leads that carry those impulses into the heart.
  • Subcutaneous ICD: This type of ICD is placed on the side of your chest, under the armpit. The lead runs along your breastbone, just underneath the skin. It remains outside your chest wall, so it’s near—but not inside—your heart. A subcutaneous ICD may be a good option when structural heart disease or other problems make it hard to place leads inside the heart.
  • Biventricular ICD: This device benefits people who have certain types of heart failure and also need an ICD. It’s also known as cardiac resynchronization therapy (CRT) or a CRT-D device. It helps your heart’s bottom chambers work together to pump more blood. And it restores your normal heart rate during periods of tachycardia.

What to expect when you receive a pacemaker or ICD

Pacemaker and ICD placement is a surgical procedure. Most procedures take a few hours from start to finish.

During your procedure

Your device placement will take place in a special room in the hospital called an electrophysiology lab. Here’s what you can expect:

  • You’ll probably only need light sedation, which keeps you awake but comfortable. If you or your provider thinks you should have general anesthesia instead, so you’re fully asleep, you’ll discuss this beforehand.
  • If your device has leads (wires), we’ll guide them into your heart through your blood vessels. This requires a small incision near your collarbone. Then we’ll place the pulse generator underneath the skin on your chest, and connect it to the leads. This usually requires a two- to three-inch incision (and local anesthetic to numb the skin).
  • For leadless pacemakers, we use a flexible tube (catheter) to guide the device through your blood vessels and into your heart. This usually requires a tiny incision in your groin.
  • For subcutaneous ICDs, we make one or two small incisions on the side of your chest. This creates a pocket for the device. Then we gently push the lead underneath the skin until it reaches your breastbone.

Your provider will let you know if you can return home the same day as your procedure, or if you’ll need to stay overnight for observation.

After your procedure

Once your new pacemaker or ICD is in place, you’ll need to keep a few things in mind:

  • Be aware of any electrical or magnetic interference that could disrupt your device. For example, you may not be able to have MRI scans, and you should hold your cell phone at least six inches away from your device. Your provider will give you a complete list of equipment to avoid and guidelines to follow.
  • As long as we’re monitoring your device remotely and it continues working properly, you should only need an in-person check-up once each year.
  • You may still need to take certain heart medications after you receive your device. For example, a pacemaker or ICD alone can’t improve high cholesterol or high blood pressure.
  • If you have an ICD for a life-threatening type of arrhythmia, you may have driving restrictions. Your provider will let you know if this applies to you.
  • Depending on which type of pacemaker you have, the battery should last anywhere from five to 15 years. Today’s ICD batteries may last up to 10 years. When it’s time to replace the battery, you’ll undergo a minor surgical procedure.

You should quickly see an improvement in your arrhythmia or heart failure symptoms, so you feel and function more like your old self.

Do you need a pacemaker or ICD?

If your provider recommends a pacemaker or ICD, make sure you explore your options. Schedule a consultation with UI Heart and Vascular Center to find the device and specialist that's right for you.

Care Team