PACEMAKER

What is a Pacemaker?

A pacemaker is a cardiac device that gets implanted in the chest and consists of a battery and wires (called leads). The leads are placed inside the heart through a blood vessel and are then connected to the battery. The number of leads that are inserted depends on the situation of the patient. The battery life of a pacemaker varies greatly on the amount of use, but on average lasts between 8-12 years.

A pacemaker is used to treat bradyarrhythmias, which are slow heart rhythms. It can also treat syncope that is secondary to a drop or pause in heart rate. A pacemaker is designed to mimic the heart’s natural pacemaker and to make sure electrical signals are making their way throughout the heart the way they should. A pacemaker has the following functionality:

Pacing

  • A pacemaker will send an electrical impulse to the heart when the heart’s own rhythm is too slow or is interrupted. The electrical impulse that is delivered starts a heartbeat. A pacemaker has a set minimum rate (lowest heart rate allowed) that is programmable by your provider and it will initiate an electrical impulse when your heart rate drops below the programmed rate.

Sensing

  • A pacemaker will “sense” or monitor the heart’s natural electrical activity. When the pacemaker senses a natural heartbeat, it will withhold a pacing pulse so it is not pacing on top of your own heartbeat.

Rate

  • Most pacemakers also have sensors that are able to detect body motion or breathing rate, which signals the pacemaker to increase your heart rate during exercise (if needed) to meet your body’s increased need for blood and oxygen.

How is a Pacemaker Implanted?

A pacemaker is implanted under local anesthesia, and occasionally under IV sedation as well. An incision is made in the upper chest (typically the left side). The leads are inserted through the incision and into a blood vessel, before being guided into the correct position in the heart. The leads are then connected to the battery, which sits inside a pocket that is created underneath the skin. The incision is closed up with internal dissolvable sutures, with the outside of the incision having steristrips or skin glue placed over the top. Prior to being discharged home, you will have the pacemaker interrogated and undergo a chest x-ray. If all is well, you will then be discharged home.

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