Cardiac Assist Devices

What is a cardiac assist device?

A cardiac assist device is a small machine a healthcare provider can put in your chest to help your heart work better. Cardiac devices can help people with abnormal heart rhythms (arrhythmias) have a regular rhythm. They can help you avoid cardiac arrest or help your heart pump blood.

In America, the U.S. Food and Drug Administration (FDA) approves these cardiac devices for use. The FDA reviews devices to ensure they’re safe and work well. Thinking about having a machine in your chest may make you uneasy, but millions of people rely on cardiac devices to help them feel better and live longer.

What are the different types of cardiac devices?​

Cardiac device types include:

• Pacemaker. This device tells your heart muscle when to contract (pump). A pacemaker’s wire (lead) usually goes into your lower right heart chamber (right ventricle).
• Biventricular pacemaker. Leads from this device touch both of your lower heart chambers (ventricles) and your right upper chamber (atrium). The device helps them pump together.
• Implantable cardioverter defibrillator (ICD). This cardiac device can shock your heart to correct its rhythm if it’s too fast. Correcting your rhythm helps protect you from sudden cardiac death.
• Ventricular assist device (VAD). This machine helps your heart pump blood to your body. It can help either side of your heart or both, but most often the left.

Why are cardiac assist devices used?

Cardiac assist devices help your heart keep a regular rhythm, avoid cardiac arrest or pump better. Your healthcare provider may recommend one for you if you have:

• Irregular heart rate
• Heart block (slow or blocked signals)
• Sick sinus syndrome (a problem with the node that sends signals)
• Long QT syndrome (long recharging time after each beat)
• Tachycardia (fast heart rate)
• Bradycardia (slow heart rate)
• Ventricular fibrillation (a life-threatening arrhythmia)
• Heart failure (inability to pump enough blood)
• Cardiomyopathy (diseased heart muscle)

How do cardiac devices work?

When a provider implants a cardiac device like a pacemaker or ICD, they put wires (leads) from the device into your heart tissue. Providers attach leadless pacemakers to your right ventricle. Contact with your heart tissue allows the device to sense what’s happening there and send an electric impulse to make your heart beat. An ICD can send a shock if you need it.

Cardiac devices follow the program your provider sets from outside your body. A small, long-lasting battery powers a cardiac device.

Some cardiac assist devices can collect information that you can send to your provider by phone or internet. This lets your provider know what’s happening in your heart without frequent visits. Looking over the data can help your provider catch changes that may be going on before they get worse.

Part of a ventricular assist device (VAD) attaches to your lower heart chamber. Another part of it (including the battery) is outside your body. A VAD’s pump takes the workload off your heart muscle.

What are the advantages of cardiac assist devices?

Advantages of cardiac devices include:

• Lifesaving protection from cardiac arrest
• Better circulation
• More regular heart rhythms
• Improved symptoms of heart rhythm issues
• Fewer hospital stays due to heart issues
• A minimally invasive procedure for some types
• Device battery life that can last six to 15 years

What are the possible side effects of cardiac assist devices?

Complications of cardiac devices (or procedures to implant them) may include:

• Bleeding
• A small puncture in your heart
• Collapsed lung (pneumothorax)
• Blood clots
• Hematoma (collection of blood)
• Issues with broken pacemaker lead wires
• Device malfunction
• Device moving out of place
• Cardiomyopathy
• Infection related to the device

How soon after treatment will I feel better?

Cardiac devices start to work when your provider finishes setting them up. They may need to adjust settings on your device before or after you leave the hospital. Staying in contact with your healthcare team can let them know how well a cardiac device is working for you. You may have a cardiac device for the short term (like a VAD if you’re waiting for a heart transplant) or for the long term (like a pacemaker or ICD).

How can I take care of myself with a cardiac device?

Follow your provider’s instructions about caring for the places where they cut into your skin. You may also need to limit your physical activity for a while. Ask your provider when you can return to working and driving.

If you have a cardiac assist device and need an MRI, talk with your provider about special steps the imaging staff will need to take. Most people with a device can have an MRI, but providers need to make sure it’s safe for you.

You shouldn’t have trouble with everyday items like cell phones, microwaves or security scanners, though.

When should I see my healthcare provider?

After your procedure, contact your provider if you have:

• Fever or chills (signs of infection)
• Pain that doesn’t get better with medicine
• Dizziness
• Heart palpitations
• Warmth, swelling, discoloration or abnormal bleeding near your surgery site

You’ll need an annual visit (and more at first) with your provider to make sure the cardiac device you have is working well. But you also can contact them any time you feel something isn’t right with the device in your chest.