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Pacemaker and Implantable Cardioverter Defibrillator Therapy

Improvements in technology over the last 20 years have allowed physicians to treat patients with symptomatic arrhythmias with a new modality, that is, device therapy.   Both techniques of implantation and device size have improved dramatically allowing previous abdominal implanted devices to be placed under the skin of the upper chest.

The indications and techniques to implant pacemaker and ICD systems will be discussed in the following pages. Permanent pacemakers have allowed physicians to effectively treat patients with sick sinus syndrome and AV block. Implantable cardioverter defibrillators have reduced the mortality related to sudden cardiac death and have become a viable treatment option in patients with ventricular tachycardia.