Other important treatments for electrical problems in the heart are pacemakers (mainly to correct slow heart rhythms leading to dizzy spells and blackouts) and implantable cardiac defibrillators (ICDs). ICDs are designed for patients at risk of dangerous heart rhythms and can deliver special pacing treatments or shocks to terminate life-threatening arrhythmias if they occur.

A special type of pacemaker has also been developed to treat patients with heart failure who are still breathless and fatigued despite drug treatment. This technique is called Cardiac Resynchronisation Therapy and uses bi-ventricular pacemakers or ICDs. I was fortunate enough to be one of the co-investigators in the first randomized trial of these devices (MUSTIC trial).

Many patients with dizzy spells and blackouts do not require pacemakers or ICDs and can be treated with lifestyle adjustments and simple precautions. An excellent resource for information is stopfainting.com.