Pacemaker

Pacemaker

A pacemaker is a small battery-operated device that’s placed (implanted) in your chest under the skin to control your heartbeat. Average pacemakers weigh as little as 1 ounce (28 grams) and size as of matchbox.

A pacemaker has two parts:

The generator contains the battery and the information to control the heartbeat. One to three leads (wires) that deliver electrical signals from pulse generator to your heart.

What are the different types of pacemaker?

Depending on your condition, you might need one of the following types of pacemakers.

• Single chamber pacemaker: This type usually carries electrical impulses to the right ventricle of your heart.
• Dual chamber pacemaker: This type carries electrical impulses to the right ventricle and the right atrium of your heart to control contractions of the two chambers in coordinated way
• Biventricular pacemaker (three leads pacemaker): Biventricular pacing, also called cardiac resynchronization therapy, is for people who have heart failure and underlying Left Bundle Branch Block (LBBB). This type of pacemaker stimulates both of the lower heart chambers (the right and left ventricles) simultaneously to make the heart to work more efficiently.

How does a pacemaker work?

Electrical impulses are sent by the pacemaker device to tell your heart to contract and produce a heartbeat. Most pacemakers work just when they’re needed – on demand. Some pacemakers send out impulses all of the time

Your doctor will talk to you about which type of pacemaker is most suitable for you, which will depend on the reasons why you need to have one.

Why do you need a pacemaker?

You need a pacemaker if your heart is pumping too quickly or slowly (heart block ). In either case, your body doesn’t get enough blood. This can cause:

• Fainting
• Near fainting
• Dizziness
• Lack of energy
• Fatigue
• Shortness of breath
• Exercise intolerance

How is pacemaker surgery performed?

Implanting a pacemaker typically takes one to two hours. You’ll receive a local anaesthesia to numb the incision site. You’ll be awake and talking during the procedure.

Your cardiologist will make a small incision below the collar bone. They’ll guide a small wire through the incision into a major vein near your collarbone. Then the cardiologist will lead the wire / lead through vein to your heart. An X-ray machine / Fluoroscopy will help guide your cardiologist through the process.

Using the wire (lead), cardiologist will attach an electrode to your heart’s right ventricle and another in right atrium. The other end of the wires (Leads) attaches to a pulse generator. This contains the battery and electrical circuits.

If you’re getting a biventricular pacemaker, your cardiologist will attach a third lead to the left ventricle. At the end, your cardiologist will close your incision with stitches.

What are the complications associated with a pacemaker?

Every medical procedure has some risks. Most risks associated with a pacemaker are from the surgical installation. They include:

• An allergic reaction to anaesthesia
• Bleeding
• Bruising
• Damaged nerves or blood vessels
• An infection at the site of the incision
• A collapsed lung, which is rare
• A punctured heart, which is also rare

Most complications are temporary. Life-altering complications are rare.