PACEMAKER

· Your heart’s SA node is your natural pacemaker (located in the upper right chamber of the
heart). It sends an electrical impulse to make your heart beat. The job of a pacemaker is to artificially
take over the role of your sinus node if it isn’t working properly.

· Electrical impulses are sent by the pacemaker to stimulate your heart to contract and produce a
heartbeat. Most pacemakers work just when they’re needed – on demand. Some pacemakers send
out impulses all of the time. This is called fixed rate.Pacemakers do not give your heart an electrical
shock.

· You may need to have an artificial pacemaker fitted if:

i) You have a particular type of heart block – a delay in the electrical signals travelling through
the heart, that can make the heart beat too slowly.

ii) Your heart is beating too fast and this is not effectively controlled by medication.

iii) You have heart failure, which may cause your heart to pump out of sync.

· Pacemakers can be temporary or permanent.

i) Temporary pacemakers are used to treat short-term heart problems, such as a slow heartbeat
that's caused by a heart attack, heart surgery, or an overdose of medicine.They also are used during
emergencies. They might be used until your doctor can implant a permanent pacemaker or until a
temporary condition goes away. If you have a temporary pacemaker, you'll stay in a hospital as long
as the device is in place.

ii) Permanent pacemakers are used to control long-term heart rhythm problems.

· Types of Pacemaker :

i) Programmable Pacemaker

ii) Demand Pacemaker

Specifications of Pacemaker

DEFIBRILLATORS

· Defibrillators are devices that restore a normal heartbeat by sending an electric pulse or shock to
the heart. They are used to prevent or correct an arrhythmia, a heartbeat that is uneven or that is
too slow or too fast. Defibrillators can also restore the heart’s beating if the heart suddenly stops.

· Types of Defibrillators:

i) Manual external defibrillator

ii) Implantable cardioverter-defibrillator

iii) Manual internal defibrillator

iv) Automated external defibrillator (AED)

v) Wearable cardiac defibrillator

 Implantable cardioverter-defibrillator

An implantable cardioverter-defibrillator (ICD) is a small battery-powered device placed in your chest

to monitor your heart rhythm and detect irregular heartbeats. An can deliver electric shocks via one
or more wires connected to your heart to fix an abnormal heart rhythm

Also known as automatic internal cardiac defibrillator (AICD). These devices are implants, similar to
pacemakers (and many can also perform the pacemaking function). They constantly monitor the
patient's heart rhythm, and automatically administer shocks for various life-threatening arrhythmias,
according to the device's programming. Many modern devices can distinguish between ventricular
fibrillation, ventricular tachycardia, and more benign arrhythmias like supraventricular tachycardia
and atrial fibrillation. Some devices may attempt overdrive pacing prior to synchronised
cardioversion. When the life-threatening arrhythmia is ventricular fibrillation, the device is
programmed to proceed immediately to an unsynchronized shock.

There are cases where the patient's ICD may fire constantly or inappropriately. This is considered a
medical emergency, as it depletes the device's battery life, causes significant discomfort and anxiety
to the patient, and in some cases may actually trigger life-threatening arrhythmias. Some emergency
medical services personnel are now equipped with a ring magnet to place over the device, which
effectively disables the shock function of the device while still allowing the pacemaker to function (if
the device is so equipped). If the device is shocking frequently, but appropriately, EMS personnel
may administer sedation.

Specifications of Defibrillator
 Types of Waveform generated by Defibrillator

Manufacturers of Pacemaker

i) Medtronic PLC,
ii) Abbott Laboratories
iii) Boston Scientific Corporation.
Manufacturers of Defibrillator
 i) Medtronic 
ii) St. Jude Medical 
iii) Boston Scientific 
iv) Biotronik 
v) Sorin Group 
vi) Philips Healthcare