The Basics Regarding Pacemaker/Defibrillator Implant Devices

Pacemakers are defined as a small electrical appliance or electronic device comprised of a generator and one or more leads that contain an electrode. Pacemakers and ICDs are implanted in the chest of patients and not in the heart, though close to the heart. The leads emit signals to the device, encouraging the heart to beat if the heartbeat is slower than it should be. Defibrillator implant devices are also known as implantable cardioverter defibrillator (ICD). While similar to pacemakers, ICDs help the heart to maintain optimal heart rhythm if heartbeat is irregular or accelerated.

Adequate cardiac function is essential for optimal health. If the heart rate is slower than it should be, oxygenated blood is unable to reach essential body organs and tissues. Lack of adequate oxygenation limits physical functions and abilities, not only for major muscle and organs, but for brain function as well. Pacemakers are designed to create electrical impulses that encourage the heart to beat at a faster pace. The pacemaker only functions when the heart rate is lower than the designated pace programmed into the pacemaker.

Electrodes attached to the end of the leads touch the heart wall and monitor electrical activity of the cardiac muscle, relaying information to the generator. Pacemaker leads are often positioned in the atrium or ventricle of the heart.

Recent research has developed a biventricular pacemaker that inserts leads into both ventricles, thereby increasing blood flow pumped through the heart. This is called cardiac resynchronization therapy.

Implantable cardioverter defibrillators (ICD) are larger than pacemakers and are designed to offer electrical shocks to the heart when heart rate increases to dangerous levels, or goes into what is known as fibrillation.

Who Benefits from Pacemakers and ICDs?
Anyone diagnosed with an abnormal heart rate that is potentially dangerous can benefit from pacemaker and ICD implantation. The procedures for inserting pacemakers or ICDs are similar and can generally be performed in a cardiac catheterization or electrophysiology lab setting. Basically, any individual who has been diagnosed with the following may benefit from such therapy procedures:

• Bradycardia - slow heartbeat
• Tachycardia - accelerated heartbeat
• Atrial fibrillation - irregular or increased atrial heartbeat
• Ventricular fibrillation - irregular or increased ventricular heartbeat
• Heart block - delayed or interrupted electrical signals within the heart

Multiple precautions are advised for individuals under consideration for pacemaker or cardioverter defibrillators, which will be discussed by your physician or cardiac specialist. In addition, your physician will take a complete physical history to determine which type of pacemaker or implantable cardioverter defibrillator will best suit your specific needs.

What Does Pacemaker or ICD Cost?
In the United States, any type of cardiac surgery or procedure can be relatively pricey. In the U.S., pacemakers or ICDs may cost between $15,000 and $50,000, not including doctor's fees, hospitalization, lab work, and most imaging and diagnostic testing. In the U.S., the cost of a pacemaker or ICD device itself generally runs around $10,000 per unit.

However, medical travelers to foreign destinations such as India may save thousands on such units as well as implantation procedures. For example, implantation of the pacemaker in India may cost roughly $1,000, although that does not include the cost of the device. The cost of a single chamber pacemaker in India runs an average of $5,400, while a double chamber device may cost $7,200, and a biventricular pacemaker may cost just over $13,000. However, these costs are all-inclusive and include doctor's fees, hospitalization, and all lab work and diagnostic testing.

Research the cost of pacemakers or ICDs both in the United States and in a variety of medical tourist destinations to compare prices, services and options.

Who Performs Pacemaker or ICD Implantation?
Heart and vascular surgeons generally perform pacemaker and cardioverter defibrillator implantation. The process does not involve open-heart surgery, and is generally performed while the patient is awake, though under mild anesthesia. If your doctor determines that you need such a device, he or she will generally refer you to a cardiac or vascular surgeon for the procedure, which is completed on an outpatient basis. Always check the credentials, training and experience of any surgeon or physician performing such procedures to ensure that he or she has been adequately trained, accredited, and certified in his or her country of origin.