All ICDs are also<unk> s (i.e. have pacing functionality), but not all<unk> s are ICDs (i.e. do not have shocking functionality)
Sinus Node Dysfunction-sinus bradycardia/arrest, sinoatrial block, chronotropic incompetence, a-fib.
Acquired AV block- 3rd degree block and 2nd degree type II
Chronic Bifascicular or Trifascicular block
After Acute MI-high mortality with persistent AV block post MI
Cardiac Resynchronization Therapy- Conduction delay (>150msec with mortality benefit) in chronic systolic heart failure further decreases EF, increases remodeling and increased MR.
Neurocardiogenic Syncope and Carotid Sinus Syndrome
Atrial
Right Atrial Appendage
Lateral RA wall
Right Ventricle
Apex
Septum
Left Ventricle (most commonly placed for cardiomyopathy or CHF)
Coronary veins along external LV wall via coronary sinus
Rarely, externally placed electrode during open surgical procedure
Right Atrial Appendage
Lateral RA wall
Apex
Septum
Coronary veins along external LV wall via coronary sinus
Rarely, externally placed electrode during open surgical procedure
Can record rhythm strips of AF, VT, and VF episodes for later review
Keeps track of % of paced vs intrinsic beats
Keeps a rate histogram, as well as % of time spent in AF
Patient most often has a pocket card indicating manufacturer
Manufacturer Hotline has patient database
Medtronic Inc. (1-800-328-2518)
St. Jude Medical Inc. (recently acquired by Abbott, Inc.) (1-800-722-3774)
Boston Scientific Inc. (1-800-227-3422)
Magnet mode - with placement of a magnet over the device, the mode changes to asynchronous (i.e. DOO or VOO). Each brand has slightly different rates
Medtronic Inc.: 85 bpm; 65 bpm when battery is ready for replacement
St. Jude Medical Inc.: 98.6 bpm; 86.3 bpm when battery is ready for replacement
Boston Scientific Inc.: 100 bpm; 85 bpm when battery is ready for replacement
Manufacturer code on pulse generator is visible on Chest Xray
Medtronic Inc. (1-800-328-2518)
St. Jude Medical Inc. (recently acquired by Abbott, Inc.) (1-800-722-3774)
Boston Scientific Inc. (1-800-227-3422)
Medtronic Inc.: 85 bpm; 65 bpm when battery is ready for replacement
St. Jude Medical Inc.: 98.6 bpm; 86.3 bpm when battery is ready for replacement
Boston Scientific Inc.: 100 bpm; 85 bpm when battery is ready for replacement
Nonmedical
Cell phones: do not interact with device
Airport security: may trigger alarm, no alteration of activity
Medical Sources
MRI: mostly safe, consult cards on device specific recs
Cardioversion: Use AP pads >8cm from device to minimize adverse effects
Unipolar Cautery - can cause sensing and pacing malfunction as well as reprogramming
Cell phones: do not interact with device
Airport security: may trigger alarm, no alteration of activity
MRI: mostly safe, consult cards on device specific recs
Cardioversion: Use AP pads >8cm from device to minimize adverse effects
Unipolar Cautery - can cause sensing and pacing malfunction as well as reprogramming
Pacemaker complication
Infection
Implantable Cardioverter-Defibrillator complication
Most commonly S. aureus or S. epidermidis
Acute coronary syndrome 
2% local wound infection; 1% sepsis/bacteremia
Myocardial rupture
Hematoma