Pacemakers

A pacemaker is a tiny device, about the size of a silver dollar, that is implanted under the skin on the chest wall with electrical leads, or wires, that are placed through an IV into a vein and passed down and into the heart. Pacemakers act as a safety net, delivering low energy pulses to the heart muscle to stimulate a beat if the heart beat slows.

When Do I Need a Pacemaker?

Peacemakers can be temporary or permanent depending on how they’re being used. Some patients may need a temporary pacemaker to assist after a heart attack or heart surgery. For others, the implantation of a pacemaker will be permanent.

For example, if it is not possible to control AFIB, either with medications or with cardiac catheter ablation, a pacemaker may be another viable option.

In other patients, over the course of their life, scar tissue may develop in the normal cardiac electrical tissue that impedes electrical activation throughout the heart.  This can cause slowing of the heart rhythm that can lead to fatigue and shortness of breath, and more rarely to dizzy, lightheaded or passing out spells.

Some pacemakers are necessary simply due to aging and resultant inefficiency of the heart.

Pacemakers can be useful for patients of all ages depending on their condition. Typically, pacemakers are implanted due to heart damage or disease caused by advanced age, excess weight or other conditions. However, some congenital disorders require that younger patients receive a pacemaker implant.

Cardiac Resynchronization Device

A special kind of pacemaker called a cardiac resynchronization device can improve cardiac efficiency in some patients with Congestive Heart Failure (CHF) and abnormal electrical activation.  This “heart failure” pacemaker has been shown to improve patients’ symptoms of and reduce hospitalizations for CHF.

Pacemaker Implantation and Function

Pacemakers are implanted over the course of a relatively quick surgical procedure. A pacemaker actually consists of two parts – a pulse generator, about the size of a silver dollar, and leads connected to tiny electrodes that transmit the pacing signal into the heart. There may be up to three electrodes in different chambers of the heart working in tandem.

Once implanted, the pacemaker is programmed and can be adjusted based on data collected from the device over time. New technology allows pacemakers to collect additional diagnostic data including breathing patterns and blood temperature and can adjust to accommodate different activity levels and consequent heartbeats. Adjustments are very easy and can be performed in your cardiologist’s office using an external programming device.

Risks and Considerations of a Pacemaker

After a pacemaker implantation, you may be asked to stay at the hospital overnight to ensure that it is working properly. You may need help driving home the next day as well as performing basic activities once you arrive home. You will be able to resume most normal activities between four and six weeks after surgery.

There will be minor discomfort at the incision sites where the pacemaker was implanted. Your cardiologist will give you a prescription for the appropriate medication, however non-narcotic medication is usually effective.

The main risk of pacemaker placement is a small chance of infection, as it is a metal device that is placed beneath the skin. Antibiotics given before and after device placement keep that risk of infection as low as 1%.

With the pacemaker now implanted in your body, you will have to avoid any electrical devices that may interfere with the pacemaker’s electrical signals. There are several ways to avoid this interference, especially by keeping electronics away from the pacemaker area and only using them for a short period of time. Please let your medical team know that you have a pacemaker before any procedure.

How Long Does A Pacemaker Last?

Pacemakers have become smaller and more reliable over the years and most will function for up to 10 years before the pulse generator (battery) needs to be replaced. A pacemaker may need to be replaced or adjusted if the device fails prematurely, if electrical signals have been disrupted or if your medical condition worsens. Regular checkups with your cardiologist will help determine when the pacemaker is not functioning properly or needs to be replaced.

Pacemakers are a safe and very effective way to ensure normal heart rhythm. For most patients, the risks of implanting the pacemaker are far lower than the potential benefits. Some patients believe that getting a pacemaker is the end of their “normal” life, however those who receive a pacemaker are typically able to perform activities that they would not otherwise be able to do. If anything, the pacemaker improves one’s lifestyle that was previously compromised due to heart disease.

For more information about pacemakers, please contact us to schedule a consultation with one of our cardiologists and see if the pacemaker or any alternate therapy may be right for you.