Slide 1: Which patient has a pacemaker and which has an implantable cardioverter-defibrillator (ICD)?

Slide 2: Let’s review the anatomy of a pacemaker. The lead: carries the current to the tip. The generator: the battery-pack or “can.” The lead tip: embedded in the myocardium.

Slide 3: How can you tell a pacemaker from an ICD? ICDs can be readily recognized by the thick coiled wire of the defibrillator portion. Pacemaker leads remain thin throughout their length.

Slide 4: The are many different types of devices that can be identified by placements of their leads. Usually lead locations can include a combination of: right ventricle, right atrium, coronary sinus (to pace the left ventricle). Lead location varies based on device indication.

Dual-chamber RA-RV pacemaker. Combination pacer and ICD with all 3 leads (aka BiV-ICD or CRT-D). Three-lead pacer only (no ICD, aka CRT-P).

Slide 5: Many apps can identify the device type and manufacturer for the EP team! Knowing the device manufacturer is important because each company uses different interrogation equipment!