John.....Cheney doesn't have a pacemaker. He has a defibrillator, a different device.

First, atrial fibrillation (A-Fib) is extremely common in heart patients who have had the number of problems Cheney has had. I was surprised that he seemingly has had little problem with A-Fib before. Some, like myself, have lived with A-Fib for years, in my case over 10. I figured Cheney was already on warfarin but I seem to be wrong.

The device he has is an ICD, Implanted Cardiac Defibrillator. While A-Fib is common and "relatively" harmless, Ventricular problems are far more serious and sudden death can occur from Ventricular Tachycardia (V-Tach). On minor ventricular events, the ICD can briefly pace the ventricle and administer some very minor shocks to help the process. Should that not work or the event is more serious, one that could easily cause death, the ICD delivers an extreme ZAP to stop the V-Tach. If the cardiac refraction is below 35% most cardiologists are recommending these devices. They're using them on kids and old folks and everyone in between because lower refraction rates can bring on a serious V-Tach condition which will result in almost immediate death.

The ICD is not rechargeable. The device will last approximately 7 years and then need to be replaced. This of course depends on usage. Cheney just had his replaced (6 years). The ICD "surgery" is very quick, about a half hour to forty-five minutes with an overnight stay to monitor the settings. Initially, an incision is made between the neck and shoulder in the upper chest, just enough to make a "pocket" for the ICD. The unit itself is about an inch and a half square. The procedure is done in a cath lab as the cath is used to place the leads correctly.   Cost for ICD and "installation" is about $90,000.

Spaw