Can you have a pacemaker and ICD at the same time?

Answered by Edward Huber

It is possible to have a pacemaker and an implantable cardioverter-defibrillator (ICD) at the same time. In fact, many devices now combine both functions into one unit for individuals who require both therapies. This combination device is commonly referred to as a “pacemaker-ICD” or “ICD with pacemaker function.”

A pacemaker is a small electronic device that is implanted under the skin, usually near the collarbone. It helps regulate the heart’s electrical activity and ensures that it beats at a normal rate. A pacemaker is typically used for individuals who have a slow heart rate or irregular heart rhythms.

On the other hand, an ICD is also a small electronic device that is implanted under the skin. It monitors the heart’s electrical activity and is designed to deliver a high-energy shock if it detects a dangerous, fast heart rhythm such as ventricular fibrillation or ventricular tachycardia. These potentially life-threatening rhythms can lead to sudden cardiac arrest if not treated promptly.

Combining both functions into one device allows for the management of both slow heart rhythms and fast, potentially life-threatening rhythms. The pacemaker component of the device continuously monitors the heart’s electrical activity and provides pacing therapy when needed to maintain a normal heart rate. If a dangerous fast rhythm is detected, the ICD component can deliver a shock to restore a normal heart rhythm.

In situations where a shock is delivered by the ICD, a “back-up” pacing mode is available for a short duration to provide support to the heart until a normal rhythm is restored. This ensures that the heart continues to beat in a coordinated manner during the recovery period.

Additionally, the ICD component of the device may also have another treatment option called anti-tachycardia pacing (ATP). ATP involves delivering a series of small electrical impulses to the heart in an attempt to terminate fast heart rhythms without the need for a high-energy shock. ATP can be effective in certain cases and may help avoid the discomfort associated with a shock.

The decision to implant a pacemaker-ICD device is made by a cardiologist or cardiac electrophysiologist based on an individual’s specific medical condition and needs. It is important to note that not all individuals with an ICD will require a pacemaker function, and the choice of device will depend on the individual’s unique cardiac needs.

The combination of a pacemaker and an ICD into one device provides a comprehensive approach to managing both slow and fast heart rhythms. This technology has significantly improved the treatment options and outcomes for individuals with certain cardiac conditions, allowing them to lead more active and fulfilling lives.