Dr. Sanghvi was interviewed on First Coast Living and discussed the topics of Atrial Fibrillation, Pacemakers and Implantable Cardiac Devices. Dr. Sanghvi is an Electrophysiologist Cardiologist with First Coast Heart & Vascualr Center.
- What is a pacemaker and why would someone need one? Pacemakers are devices that are about the size of a silver dollar. They are placed under the skin usually below the collar bone. They typically have anywhere from 1-3 wires that enter the heart via a blood vessel under the collar bone. These devices are usually placed in patients who suffer from a slow heart beat which results in a number of symptoms including fatigue, shortness of breath, inability to exercise, lightheadedness, or fainting to name a few.
- What is a defibrillator, also known as an ICD, and why would someone need one of these devices? ICDs are implantable devices that are placed in similar fashion as a pacemaker. However, an ICD’s job is typically to treat fast and lethal irregular beats known as ventricular tachycardia (VT) or ventricular fibrillation (VF). Many people know that heart disease is the #1 killer in the US. What many do not know is that the reason most patients die is due to untreated VT or VF. Approximately 450,000 people die each year in the US from these arrhythmias. Patients at the highest risk include those who have had a prior heart attack, especially if this has resulted in a weakened heart muscle. Those with a weak heart muscle for other reasons are also at risk. Also, patients who may have had several episodes of passing out without an explanation should be evaluated since a small portion of these patients are likely suffering from VT and/or VF.
- If a patient needs to have a device implanted, what type of device should be used? This is a decision that is typically made by the implanting surgeon. There are several manufacturers of devices in the US. Many of the devices have similar features. However, there are some distinct differences.
- What happens if there is a problem with one of the wires or if one device type needs to be changed to another? Sometimes these devices may have a wire malfunction or one of the wires may be recalled due to a suspected risk of malfunction. Many surgeons often place a new wire in the heart and leave the old wire abandoned there since they are not capable of taking out the old wire. Unfortunately, this increases the risk of infections and for blood vessels to clot since there is more hardware in the body. Patients should seek out surgeons that specialize in lead extractions. Dr. Neil Sanghvi is able to utilize a laser to carefully and safely tease out the old lead that has scarred into the heart. The risk of a major complication is often less than 1-2% in many cases. The advantage is that it allows for less hardware to remain in the body which decreases the risks of infection and blood vessel clotting.