Our physicians are expert in the placement of these implantable devices. A pacemaker is placed under the skin (usually at the shoulder) with wires extending through the veins into the heart. Electrical signals from the pacemaker can be used to increase heart rate when the electrical system of the heart fails or is diseased. In addition to being able to act as a pacemaker, an implantable defibrillator senses dangerous, life threatening heart rhythms (ventricular tachycardia and ventricular fibrillation) and shocks the heart back into normal rhythm, which can be life-saving. This may be recommended either after a life-threatening event which the patient has been lucky enough to survive, or more commonly as a preventative measure in patients who are at high risk for future events of ‘sudden cardiac death.’