Pacemakers (and ICD's) have made a remarkable contribution to the health and survival of millions of patients worldwide. They are very sophisticated and complex devices capable of countless functions and measurements which are potentially helpful in the care of patients in whom these devices are implanted. Following device implant, regular Specialist follow- up is a critical element in checking the safety of device therapy, the programmed settings, and ensuring optimal benefit from the device.
Frequency of Follow Up
Following implantation, the following follow up schedule is routinely followed, with some exceptions:
- Device check one day post-operatively.
- First formal review one month following discharge.
- Further review three months later.
- Further review six months later.
- Then routine review either six monthly or twelve monthly depending on individual circumstances... until or unless there are any signs of battery depletion or any other concerns necessitating more frequent review.
Purposes of Routine Monitoring
- Checking and optimizing pacemaker programming - different for every individual.
- Checking thresholds for pacing and sensing and ensuring adequate margins of safety for programmed settings.
- Assessment of battery status and predicted device longevity.
- Checking device wounds, and general cardiology review.
- Checking for any effects of electromagnetic interference (e.g. surgical procedures).
- To detect, evaluate and occasionally treat any heart rhythm disturbances detected by the device.
- Evaluation of any symptoms that may be referable to the pacing or ICD device system.
Implantable Cardioverter Defibrillator (ICD's)
These devices all contain pacemakers and all the above comments pertain. In addition, careful review of specific arrhythmia information and device functionality is separate.