Pacemakers, Defibrillators & Implanted Devices

Our team works with pediatric cardiologists, cardiothoracic surgeons, cardiac anesthesiologists, cardiac psychologists, advanced practice providers, nurses and technicians with specialized experience in implanted cardiac devices. You get the highest quality of care and support in one place.

Depending on your child’s condition we may use: 

• Pacemakers, or devices implanted under the skin that send electrical impulses to the heart to maintain a regular heart rate and rhythm
  
• Defibrillators, or devices that restore normal heart rhythm by delivering an electric shock to the heart in the event of life-threatening arrhythmias or cardiac arrest
• Implantable cardioverter defibrillators (ICDs), or devices placed under the skin that continuously monitor heart rhythm and deliver shocks when dangerous arrhythmias are detected
• Cardiac resynchronization therapy (CRT), or devices that coordinate the pumping of the heart's lower chambers and improve blood flow by sending small electrical impulses, which can be used to treat heart failure
• Implantable heart monitors, or devices placed under the skin to continuously monitor, for more than a year, heart rhythm and causes for fainting

Nemours provides the full range of device care for your child’s exact needs. We offer:

• Device implantation using catheters (thin tubes) threaded through blood vessels or minimally invasive surgical methods
  
• Education and training on how devices work, care and maintenance, safety and more  
• Follow-up care, closely managing your child’s health, testing device function, and making adjustments as needed 
• Remote heart monitoring, using the Nemours app on a mobile device to continuously track heart rhythm and other vital signs from our office
• Troubleshooting and device maintenance to help with complications or component replacement
• Lead extraction, or surgically removing the thin wires implanted in the heart due to damage, infection or required upgrade
• Cardiac psychology support for the whole family with special programs to strengthen your child’s behavioral and learning development 
• Support services at the very start, from social work to Child Life and more

Learn More About Cardiac Devices

Pacemakers, implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy with defibrillators (CRT-Ds) have similar parts that provide different types of support. 

They involve a battery-powered pulse generator and one or more wires, called leads, with electrodes at the ends. The electrodes are placed in the heart chambers and other areas as needed. The pulse generator receives electrical signals from the heart and, as programmed, sends an electrical pulse to help restore normal heart rhythm. 

Pacemakers

Pacemakers are used to treat slow heart rate, or bradycardia and heart block. They focus on regulating and maintaining a normal heart rate. The leads are placed in the heart chambers and deliver a low-energy pulse when the heart beats too slowly. Wireless pacemakers are all one piece and do not have leads. 

ICDs

ICDs are designed to treat life-threatening, fast or irregular heart rhythms, like ventricular tachycardia or certain forms of cardiomyopathy. Like pacemakers, the leads are placed in the heart chambers. When the heart beats too quickly or with an odd rhythm, a higher-energy shock is sent to restore the heart’s rhythm. 

CRT-Ds

CRT-Ds are like pacemakers and ICDs, but they also offer cardiac resynchronization therapy. They help children who need more advanced heart rhythm support, like those with heart failure (when the heart doesn’t pump as it should). Leads are placed in the heart chambers, with an additional lead placed to stimulate the left side of the heart. This makes the heart’s pumping action more efficient. 

What to Expect

Device Implantation

For some children we can implant devices using a transvenous approach. This means it’s inserted into the heart through a blood vessel, usually under the collarbone. This method uses catheters, or thin tubes guided by special X-ray imaging. It’s done in a special lab by electrophysiologists.

For others, we may use small cuts in the chest to place the device. A cardiothoracic surgeon performs this procedure. 

In general, device implantation can take about four to six hours. Most kids will stay at the hospital overnight. They’ll need about six weeks before they can participate in intense, tiring activities. 

Living With Implanted Devices

Children with implanted devices can and do live active lives. 

Devices like pacemakers are safe and regular household appliances (microwaves, televisions, computers or cell phones) won’t interfere with them. Some items with strong magnets can, such as MRI machines, metal detectors and certain surgical tools. We’ll give you all the information you need to keep your child safe.

Be sure to inform your child’s health providers, including their dentist, about their device.