Pacemaker & ICD Implantation

Pacemaker and implantable cardioverter-defibrillator (ICD) implantation are device-based therapies for bradyarrhythmias and life-threatening ventricular arrhythmias respectively, delivered by our electrophysiology team in a dedicated cardiac device laboratory. Pacemakers deliver electrical impulses to correct abnormally slow heart rhythms caused by sinus node dysfunction or atrioventricular block, ensuring the heart maintains an adequate rate to support normal activity. ICDs continuously monitor heart rhythm and deliver a defibrillation shock when ventricular fibrillation or haemodynamically unstable ventricular tachycardia is detected.

Device implantation is performed under local anaesthesia and light sedation, typically taking 60 to 90 minutes. Leads are advanced transvenously through the subclavian or cephalic vein under fluoroscopic guidance and secured within the right ventricular apex, right atrium, and — for cardiac resynchronisation therapy (CRT) devices — the left ventricle via the coronary sinus. The device generator is implanted in a subcutaneous pocket beneath the clavicle. Subcutaneous ICD (S-ICD) is available for patients without pacing indication, avoiding transvenous leads entirely and reducing the risk of lead-related complications.

Cardiac resynchronisation therapy (CRT) — using a biventricular pacemaker or CRT-D combining resynchronisation with defibrillation — is offered to patients with heart failure and bundle branch block, coordinating left and right ventricular contraction to improve cardiac output and reverse adverse cardiac remodelling. Remote monitoring through dedicated device management platforms enables our team to review device function, arrhythmia episodes, and fluid status parameters between clinic visits, with automatic alerts generated when actionable findings are detected. All device patients receive a structured follow-up programme with regular in-person device checks and continuous remote surveillance.