A defibrillator is a permanent implant similar to a pacemaker, which can prevent life-threatening arrythmias, such as ventricular tachycardias, which can result in sudden death. Defibrillators are recommended for patients with weakened heart muscles and they re-establish the body's natural pacemaker in the heart. For more information, or to see if you are a candidate for a defibrilator, consult with your cardiologist.


A pacemaker is a small electrical device that is placed inside the body to help the heart maintain a regular beat. A pacemaker may be needed when you heart’s natural pacemaker is not working properly. 

Your pacemaker will need to be checked periodically. Your cardiologist will provide all the information you will need for pacemaker care following implantation. 

Defibrillator & Pacemaker Clinic

James River Cardiology Practice offers follow-up assistance for patients who have recently received a pacemaker or defibrillator. This includes periodic routine visits that can help detect problems and prevent symptoms from affecting your independence and activities of daily living. 

When Do Follow-up Services Start?
Follow-up services should begin within seven to 10 days after your pacemaker has been implanted. It is recommended that you bring someone to accompany you for this first appointment. This visit typically lasts about one hour, during which you will receive a monitoring unit, or “transmitter,” along with complete instructions for its use. 

Transtelephonic Monitoring
About one month following implantation you will be scheduled for a telephone test. At an appointed time, our technician will call you at home to test your device over the phone. This test takes less than five minutes and the results are reviewed at its conclusion. Each test is reviewed by your cardiologist and recorded in your medical file. 

Threshold Testing
Pacemaker clinic visits are referred to as “threshold testing.” These visits occur once or twice a year as prescribed by your physician. A registered nurse trained in pacemaker device therapy performs this evaluation, which takes approximately 30 minutes. The nurse checks your vital signs and discusses possible pacemaker-related symptoms. The nurse also examines your pacemaker pocket and performs a series of noninvasive, painless tests to analyze the pacemaker's function. 

The pacing system includes the pulse generator, the lead(s) connecting the pacemaker to the heart and you, the patient. Threshold testing helps the nurse determine if your pacemaker settings are programmed appropriately. Correct settings increase the longevity of the pacemaker generator. The test results are interpreted by a cardiologist and kept in your record. 

Follow-up for Other Devices
Internal cardioverter defibrillator (ICD) follow-up is similar to pacemaker clinic visits. The appointments last approximately 45 minutes and can be as frequent as every three months. 

A nurse will check your vital signs and perform an analysis of your ICD. Following this analysis, your results are reviewed by the cardiologist.