Collaborative care for pacemaker and ICD patients.

Decoding Pacemakers and ICDs: What Non-Cardiologists Need to Know

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"A concise guide to understanding pacemakers and ICDs for medical professionals outside of cardiology."

The world of implantable cardiac devices is expanding rapidly. In Germany alone, over 75,000 pacemakers and more than 28,000 ICDs (Implantable Cardioverter Defibrillators) are implanted each year. This means a significant number of patients with these devices are under the care of general practitioners and internists, making a foundational understanding of these devices crucial, even outside of cardiology.

While cardiologists specialize in the implantation and management of pacemakers and ICDs, other medical professionals play a vital role in the ongoing care of patients with these devices. Recognizing potential issues, understanding basic device functions, and knowing when to consult a specialist are all essential for providing comprehensive patient care.

This article aims to bridge the knowledge gap for non-cardiologists. We'll explore key aspects of ICD and pacemaker implantation, discuss common complications and their management, and introduce emerging technologies in cardiac rhythm management. By providing a clear and concise overview, we empower you to confidently care for your patients with these life-saving devices.

Understanding Pacemaker and ICD Therapy: Key Considerations for Non-Cardiologists

Collaborative care for pacemaker and ICD patients.

Let's delve into the essential considerations for non-cardiologists managing patients with pacemakers and ICDs. We'll cover the basics, potential complications, and the importance of collaborative care.

The following aspects of pacemaker and ICD therapy are crucial for non-cardiologists:

Indications for Device Implantation: Understand the guideline-driven reasons for implanting pacemakers and ICDs. This knowledge helps you assess whether a patient's symptoms or condition warrant referral for device consideration.
Device Malfunctions and Troubleshooting: Become familiar with common device malfunctions and their initial management. Early recognition can prevent serious complications. Device failures, though rare, need to be identified quickly.
Post-operative Complications: Be aware of potential early and late complications following device implantation. This includes infection, lead dislodgement, and hematoma formation.
MRI Considerations: Understand the safety protocols for magnetic resonance imaging (MRI) in patients with pacemakers and ICDs. Some devices are MRI-conditional, requiring specific programming adjustments before and after the scan.
End-of-Life Care: Know how to manage device programming for patients receiving palliative care. This may involve deactivating certain device functions to improve patient comfort.

By understanding these key considerations, non-cardiologists can play a crucial role in the holistic care of patients with pacemakers and ICDs.

The Future of Cardiac Rhythm Management: A Collaborative Approach

The management of patients with pacemakers and ICDs is evolving. Technological advancements, such as leadless pacemakers, are changing the landscape of cardiac rhythm management, potentially reducing complications associated with traditional devices.

These advancements underscore the importance of continued education and collaboration between specialists and general practitioners. A coordinated approach ensures patients receive the best possible care throughout their journey with these devices.

By fostering open communication and shared knowledge, we can optimize the well-being of patients with pacemakers and ICDs, improving their quality of life and long-term outcomes. This interdisciplinary collaboration between general practitioners, internal medicine specialists, and cardiologists is crucial for proactively addressing problems in these patients.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1055/a-0560-3240, Alternate LINK

Title: Herzschrittmacher Und Icd – Wichtige Kenntnisse Für Nicht-Kardiologen

Subject: General Medicine

Journal: DMW - Deutsche Medizinische Wochenschrift

Publisher: Georg Thieme Verlag KG

Authors: Nikolaus Marx

Published: 2018-10-30

Everything You Need To Know

What are pacemakers and ICDs, and why are they important?

Pacemakers and Implantable Cardioverter-Defibrillators (ICDs) are implantable cardiac devices used to manage heart rhythm disorders. Pacemakers are primarily used to treat slow heart rhythms (bradycardia), while ICDs are designed to detect and correct dangerously fast heart rhythms (tachycardia), which can lead to sudden cardiac arrest. The devices constantly monitor the heart's electrical activity. When the heart rhythm deviates from a safe pattern, the devices deliver electrical impulses or shocks to restore a normal rhythm. Their significance lies in their ability to prevent or treat life-threatening arrhythmias, improving patient outcomes and quality of life.

What kind of malfunctions can happen with pacemakers and ICDs?

Device malfunctions can occur with both pacemakers and ICDs. Some common issues include battery depletion, lead dislodgement or failure, and device malfunction. Early recognition is important because it can prevent serious complications. Understanding of the indications for device implantation is crucial, as it helps in assessing whether a patient's symptoms or condition warrant referral for device consideration. Device failures, though rare, need to be identified quickly so that the patient's health is prioritized.

What complications might occur after the implantation of a pacemaker or ICD?

Potential post-operative complications include infection, lead dislodgement, and hematoma formation. Infections can occur at the device pocket site or along the leads, requiring antibiotic treatment or device removal. Lead dislodgement, where the leads move from their original position in the heart, can lead to ineffective pacing or shocking. Hematoma formation, or the collection of blood around the device, can cause pain, swelling, and device malfunction. Recognizing these complications is critical for timely intervention and management. Also, the patient will need to consult with their cardiologist.

Are MRIs safe for patients with pacemakers and ICDs?

MRI safety is an important consideration for patients with pacemakers and ICDs. Some devices are MRI-conditional, meaning they can be safely used in an MRI machine under specific conditions. Before an MRI, the device may need to be reprogrammed to a special mode to minimize the risk of malfunction during the scan. After the scan, the device must be reprogrammed back to its original settings. Non-cardiologists should be aware of these protocols and consult with a cardiologist or device clinic to ensure patient safety.

How are pacemakers and ICDs managed in end-of-life care?

When a patient is receiving palliative care, the device programming may be adjusted to improve their comfort and quality of life. This may involve deactivating certain device functions, such as the ability to deliver shocks, if they are no longer beneficial or consistent with the patient's goals of care. These decisions should be made in consultation with the patient, their family, and the cardiologist, focusing on providing compassionate end-of-life care.