Pacemakers and ICDs

Pacemakers are generally use to treat slow heart rhythms. Many of the patients who need pacemakers are older, though pacemaker implantation can be necessary in younger people too.


Although often fiddly we regard pacemaker implantation as a minor proceure and it should not take more than an hour or two



A newer application of pacemaker therapy is for people with breathlessness due to poor heart function. I have the largest experience in the South West for this type of procedure.  In some cases it is possible to resynchronise the action of the heart by pacing both pumping chambers. This is referred to as cardiac resynchronisation therapy (CRT). If you have heart failure you should have an ECG to see if you have left bundle branch block and so may benefit from this treatment  

Defibrillators (ICDs) are useful in people who seem to be at risk from a life threatening arrhythmia. The device works as a pacemaker if required but can also deliver a shock to the heart if the rhythm should degenerate, restoring normal rhythm.

ICDs are implanted both for those who have suffered a serious arrhythmia and recovered and for those who seem to be at risk of serious arrhythmias in the future.

The place of ICD therapy is very closely controlled in the UK by recommendations from NICE, since these devices are very expensive (£10,000-15,000)