Welcome to the Non-Invasive Cardiac Laboratory (NICL) at Hospital Sultan Idris Shah.

If you have an implanted cardiac device—such as a permanent pacemaker, an implantable cardioverter-defibrillator (ICD), a cardiac resynchronization therapy (CRT) device, or an implantable loop recorder (ILR)—regular device interrogation checkups are an essential part of your ongoing care. This guide explains what the procedure involves, how to prepare, and what to expect during your appointment.

What is Cardiac Device Interrogation?

Cardiac device interrogation is a routine, painless, and completely non-invasive checkup of your implanted heart device.

Using an external programming computer equipped with a specialized wireless wand (telemetry head), our cardiac technologist or cardiologist communicates directly with your device through your skin. No surgery, needles, or invasive procedures are involved.

The programmer reads data stored inside your device’s computer chip, giving our medical team a detailed summary of your heart’s rhythms, the device’s electrical performance, and its battery health.

Which Devices Are Interrogated?

Permanent Pacemakers (PPM): Devices that keep the heart from beating too slowly (bradycardia).
Implantable Cardioverter-Defibrillators (ICD): Devices that monitor for dangerously fast, life-threatening heart rhythms and deliver life-saving pacing or electrical shocks if necessary.
Cardiac Resynchronization Therapy (CRT-P / CRT-D): Specialized biventricular devices used in heart failure patients to ensure both lower chambers pump in harmony.
Implantable Loop Recorders (ILR): Small subcutaneous diagnostic monitors inserted under the skin to record long-term heart rhythm patterns over several years.

Why is Routine Device Interrogation Essential?

Even if you feel completely well, regular checks are crucial to:

Check Battery Longevity: Measure remaining battery voltage and estimate how many years of battery life remain before a generator replacement is needed.
Verify Lead Function: Test the integrity of the wires (leads) connecting the device to your heart muscle (checking electrical resistance/impedance, signal sensing, and stimulation thresholds).
Review Stored Heart Events: Download saved logs of arrhythmias (such as silent episodes of Atrial Fibrillation or Ventricular Tachycardia) and record any therapy delivered (e.g., anti-tachycardia pacing or defibrillator shocks).
Fine-Tune Device Settings: Adjust pacing rates, energy output, or sensitivity thresholds to match changes in your health, lifestyle, or medications—optimizing heart performance while preserving battery life.

How to Prepare for Your Appointment

1. Bring Your Device Identification Card (Mandatory) 💳

Always bring your manufacturer-issued Cardiac Device ID Card (Medtronic, Boston Scientific, Abbott / St. Jude Medical, or Biotronik).
This card contains critical information, including your device model, serial number, date of implant, and lead model numbers, allowing the technologist to select the exact programming system needed.

2. Food, Drink & Daily Medications 🍽️💊

You do not need to fast. You may eat and drink normally before your appointment.
Take all your daily prescribed medications on schedule as usual.
Bring a printed list of your current medications or the physical medication boxes with you.

3. Clothing 👕

Wear comfortable, loose-fitting two-piece clothing (a shirt that buttons or zips in front is ideal). The technician needs easy access to the skin overlying your device (typically under your left or right collarbone).
Avoid wearing necklaces, chains, or heavy metallic accessories around your chest and neck.

4. Notes on Symptoms or Shocks 📝

If you felt your device deliver a shock, had unexplained fainting spells, dizziness, or felt palpitations since your last visit, write down the approximate date and time so the team can cross-examine the device’s internal log.

What to Expect During the Procedure

A routine interrogation usually takes 15 to 30 minutes.

Positioning: You will be seated comfortably in a clinic chair or asked to lie on an examination couch.
Placing the Programmer Wand: The technician or doctor will place a smooth, lightweight wand or telemetry sensor directly over your clothes or bare skin where the device is implanted under your collarbone. Some modern devices communicate via secure radiofrequency (RF) signals, allowing communication from a short distance without direct skin contact.
Data Retrieval: The programmer reads the stored diagnostic information. You will hear quiet electronic beeps from the programming console as it connects and gathers data.
Active Threshold Testing (What You Might Feel):
- During testing, the technician will briefly adjust the pacing rate to measure the minimum electrical energy required to stimulate your heart.
- You may temporarily feel your heart beating slightly faster, fluttering, or slowing down for a few seconds. This is completely expected, safe, and controlled.
- If you have a defibrillator (ICD), the testing evaluates settings electronically—it will not deliver an electrical shock during a routine check.
Adjustments: If any parameters need optimization, the technician will reprogram the device wirelessly via the console in real time.

What Happens After the Check?

Immediate Review: You will receive immediate feedback regarding your device’s battery status, lead health, and whether any abnormal heart rhythms were detected.
No Restrictions: The check causes no pain, fatigue, or lingering effects. You can resume driving, working, and normal daily activities immediately.
Scheduling Your Next Visit: Most stable devices need to be checked every 6 to 12 months, depending on battery age and clinical condition. The team will give you your next appointment slip before you leave.

Questions or Need to Reschedule?

📍 Location: Non-Invasive Cardiac Laboratory (NICL), Hospital Sultan Idris Shah, Jalan Puchong, 43000 Kajang, Selangor.

📞 Phone: +603-8947 5555

✉️ Email: admin@nicl.my

Versi Bahasa Melayu: Memahami Pemeriksaan Peranti Jantung (Cardiac Device Interrogation)

Selamat datang ke Makmal Kardiologi Non-Invasif (NICL), Hospital Sultan Idris Shah.

Sekiranya anda menggunakan peranti implan jantung—seperti perentak jantung (pacemaker), penyahfibrilator kardioverter implan (ICD), terapi penyegerakan jantung (CRT), atau perakam gelung implan (ILR)—pemeriksaan berkala peranti (device interrogation) adalah sebahagian daripada penjagaan kesihatan jantung anda. Panduan ini menerangkan tujuan pemeriksaan, persediaan yang perlu dilakukan, serta langkah prosedur yang akan dilalui.

Apakah itu Pemeriksaan Peranti Jantung (Device Interrogation)?

Pemeriksaan peranti jantung ialah prosedur susulan rutin yang tidak menyakitkan dan bukan invasif (tanpa sebarang pembedahan atau suntikan) untuk menilai status serta fungsi peranti implan jantung anda.

Dengan menggunakan mesin pengaturcaraan khas (programmer) yang dilengkapi alat penderia telemetri tanpa wayar (wand), juruteknologi atau pakar kardiologi boleh berkomunikasi secara langsung dengan mikrocip peranti dari luar kulit dada anda.

Mesin ini membaca data diagnostik yang tersimpan di dalam peranti, membolehkan pasukan perubatan menilai corak ritma jantung anda, kecekapan fungsi wayar elektrik, serta jangka hayat bateri yang tinggal.

Peranti yang Terlibat dalam Pemeriksaan Ini

Perentak Jantung Kekal (Permanent Pacemaker / PPM): Membantu menghalang denyutan jantung daripada menjadi terlalu perlahan (bradycardia).
Penyahfibrilator Kardioverter Implan (Implantable Cardioverter-Defibrillator / ICD): Memantau ritma laju yang berbahaya (tachycardia/fibrillation) dan memberikan terapi perentakan atau kejutan elektrik penyelamat nyawa jika diperlukan.
Terapi Penyegerakan Jantung (Cardiac Resynchronization Therapy / CRT-P & CRT-D): Digunakan bagi pesakit kegagalan jantung untuk memastikan kedua-dua ruang bilik bawah jantung mengepam secara serentak.
Perakam Gelung Implan (Implantable Loop Recorder / ILR): Alat perakam mini di bawah kulit untuk merakam ritma jantung bagi tempoh masa panjang (sehingga beberapa tahun).

Mengapa Pemeriksaan Berkala Ini Sangat Penting?

Walaupun anda berasa sihat dan cergas, pemeriksaan berkala wajib dilakukan untuk:

Memeriksa Jangka Hayat Bateri: Mengukur baki voltan bateri dan menganggarkan tempoh tahun sebelum unit penjana (generator) perlu diganti baharu.
Memeriksa Keadaan Wayar (Leads): Menguji ketahanan wayar elektrod yang menyambungkan peranti ke otot jantung (memeriksa rintangan elektrik/impedans, kepekaan sensor, dan tahap ambang tenaga).
Menyemak Log Rentak Jantung Tersimpan: Memuat turun rekod gangguan ritma yang berlaku tanpa disedari (seperti fibrilasi atrium tersembunyi) serta rekod sebarang terapi kejutan atau perentakan yang telah diberikan oleh peranti.
Pengubahsuaian Tetapan (Reprogramming): Mengoptimumkan kadar degupan peranti mengikut tahap aktiviti, gaya hidup, atau perubahan ubat anda—meningkatkan keberkesanan rawatan sambil menjimatkan penggunaan bateri.

Persediaan Sebelum Menghadiri Temujanji

1. Wajib Membawa Kad Pengenalan Peranti (Kad ID Peranti) 💳

Bawa Kad Pengenalan Peranti Jantung anda (dikeluarkan oleh syarikat pengeluar seperti Medtronic, Boston Scientific, Abbott / St. Jude Medical, atau Biotronik).
Kad ini mengandungi maklumat model peranti, nombor siri, tarikh pemasangan, dan jenis wayar plumbum, bagi membolehkan petugas memilih mesin pengaturcara yang tepat.

2. Makanan, Minuman & Ubat Harian 🍽️💊

Anda tidak perlu berpuasa. Anda boleh makan dan minum seperti biasa sebelum hadir ke temujanji.
Teruskan mengambil ubat-ubatan harian seperti biasa mengikut jadual.
Bawa senarai atau kotak ubat terkini anda ke klinik.

3. Pakaian 👕

Pakai pakaian longgar dua helai (baju berkancing butang atau berzip di hadapan adalah disyorkan). Ini memudahkan petugas meletakkan penderia pada kawasan dada (di bawah tulang selangka kiri atau kanan).
Elakkan memakai rantai leher atau barang kemas logam yang tebal di bahagian dada.

4. Catatan Simptom atau Kejutan Elektrik 📝

Sekiranya anda pernah merasakan kejutan daripada peranti ICD, episod rasa pitam, atau debaran sejak temujanji terdahulu, catatkan tarikh dan anggaran masa kejadian agar pasukan perubatan boleh menyemak log masa pada peranti.

Apa yang Berlaku Semasa Pemeriksaan?

Pemeriksaan rutin biasanya mengambil masa antara 15 hingga 30 minit.

Kedudukan: Anda akan diminta duduk di kerusi khas atau berbaring di atas katil pemeriksaan.
Pemasangan Penderia Telemetri: Petugas akan meletakkan alat penderia (wand) di atas baju atau permukaan kulit dada di mana peranti anda berada. Bagi peranti moden yang menggunakan frekuensi radio (RF), data boleh disambungkan secara automatik tanpa sentuhan fizikal rapat.
Pemindahan Data: Mesin pengaturcara akan membaca data yang tersimpan. Anda mungkin mendengar bunyi bip elektronik dari konsol komputer semasa proses komunikasi berlangsung.
Ujian Ambang (Threshold Testing):
- Petugas akan membuat sedikit simulasi kelajuan degupan jantung untuk menguji tahap tenaga minimum yang diperlukan untuk merangsang jantung anda.
- Anda mungkin berasa degupan jantung anda berdegup laju sedikit, bergetar, atau perlahan seketika selama beberapa saat. Ini adalah normal, terkawal, dan selamat.
- Bagi pesakit yang memakai ICD, ujian ini hanya menilai tetapan secara elektronik—tiada sebarang renjatan elektrik akan diberikan semasa pemeriksaan rutin.
Pengemaskinian Tetapan: Sekiranya sebarang pelarasan diperlukan, petugas atau pakar kardiologi akan mengemas kini arahan peranti terus melalui sistem tanpa wayar.

Apa yang Berlaku Selepas Pemeriksaan?

Penerangan Keputusan: Anda akan dimaklumkan secara terus mengenai baki ketahanan bateri peranti, status wayar elektrod, dan sama ada sebarang gangguan rentak jantung telah dikesan.
Tiada Kesan Sampingan: Pemeriksaan ini tidak menyebabkan kesakitan atau keletihan. Anda boleh memandu, bertugas, dan meneruskan aktiviti harian serta-merta selepas keluar dari bilik ujian.
Temujanji Seterusnya: Bagi peranti yang stabil, pemeriksaan susulan biasanya dijadualkan setiap 6 hingga 12 bulan. Kad temujanji baharu akan diberikan sebelum anda pulang.

Sebarang Pertanyaan atau Penjadualan Semula?

📍 Lokasi: Makmal Kardiologi Non-Invasif (NICL), Hospital Sultan Idris Shah, Jalan Puchong, 43000 Kajang, Selangor.

📞 Telefon: +603-8947 5555

✉️ Emel: admin@nicl.my