Pacemakers and implantable cardioverter-defibrillators (ICDs) treat different electrical problems of the heart. A pacemaker is commonly used when the heart rhythm is too slow or electrical conduction is impaired. An ICD is designed for selected patients at significant risk of dangerous ventricular arrhythmias and sudden cardiac death. The choice of device depends on the rhythm diagnosis, heart function, symptoms and individual risk rather than on a generic device package.
Pacemaker and ICD indications are different
DHZC Charité describes pacemakers for clinically relevant bradycardia or conduction disorders, while ICDs are used in selected patients at increased risk of malignant ventricular arrhythmias or sudden cardiac death. Some patients may need devices that also provide cardiac resynchronization therapy, depending on heart failure and electrical dyssynchrony.
Records for an electrophysiology review
A German rhythm team needs evidence of the rhythm problem and cardiac function.
- 12-lead ECG
- Holter or event-monitor reports
- Echocardiography and ejection fraction
- Previous electrophysiology or ablation reports
- History of fainting, cardiac arrest or documented ventricular arrhythmia
- Current cardiac medication
- Existing device card and interrogation reports if a device is already implanted
Device selection is more than brand choice
The clinical question includes whether pacing is needed, how many chambers should be paced, whether defibrillation is required, whether resynchronization is appropriate and whether a transvenous, subcutaneous or other system fits the individual anatomy and risk profile.
Follow-up must be planned before travel home
Implanted devices require wound review and periodic device interrogation. International patients should confirm how early post-operative checks will be performed, when travel is reasonable and whether a local cardiology service can monitor the specific device after return.
Existing leads and revisions are a separate pathway
Lead malfunction, infection or extraction can be substantially more complex than a first implant. Send previous device records and operative reports so the center can assess the actual revision problem rather than pricing or planning it as a routine new implant.
Sources and review
This guide was last source-reviewed on 2026-08-29.