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Pacemakers
Frequently Asked Questions About Implanted Cardiac Pacemakers
What is a pacemaker?
A pacemaker is a small, battery-powered device that is implanted permanently into the body. The pacemaker monitors the electrical impulses in the heart and, when needed, delivers electrical stimuli to make the heart beat (contract) in a more normal pattern.
When is it used?
A pacemaker is used when the heart beats too slowly (bradycardia) or has other abnormal rhythms (arrhythmias). In some cases, pacemakers are also used to treat the symptoms of heart failure.
How does it work?
A pacemaker consists of a battery and electrical circuitry (a minicomputer) referred to as a pulse generator. The battery powers the pacemaker. The circuitry checks the heart rate and produces tiny electrical pulses that keep the heart beating at the correct pace.
The pacemaker is connected to the heart through one to three insulated wires (leads) that are attached directly to the heart's chambers.
Some pacemakers can be customized to meet specific needs.
- Rate - Responsive Pacemakers These pacemakers may be programmed to increase or decrease heart rate to match your activities (i.e., resting or walking).
- Single Chambered Pacemakers These pacemakers use only one lead placed into the right upper chamber of the heart (right atrium) or the right lower chamber (right ventricle).
- Dual Chambered Pacemakers These pacemakers have two leads. One is placed in the right atrium, the other in the right ventricle.
- Cardiac Resynchronization Therapy Pacemakers These pacemakers have three leads. One is in the right atrium, one is in the right ventricle and one is placed through the heart's vein to the left ventricle. These pacemakers are used to help treat heart failure.
What will it accomplish?
A pacemaker helps restore a normal heart rate so that the heart can pump more effectively. This can reduce or stop the symptoms of abnormal heartbeats (arrhythmias), such as dizziness, confusion, fainting, or fatigue.
What should I expect during the procedure?
You will be given some IV sedation prior to the beginning of the procedure but will remain awake, but a little drowsy. This is so the physician can talk with you during the procedure. A local anesthetic is given by injection to numb the area where the pacemaker will be inserted. This keeps you from feeling pain during the procedure. An incision is made where the generator is placed. The lead wire is inserted through a vein into your heart's chambers using x-ray monitors. The pacemaker generator is attached to the lead or leads. The pacemaker is placed into a pocket made under the fatty layer of the tissue but over the muscle layer. The incision is then closed with sutures or surgical clips.
What should I expect after the procedure?
Don't raise your arm on the incision side above your shoulder for the first 3 weeks. This gives the lead a chance to secure in your heart. You will have your pacemaker checked using specialized equipment (programmer) and adjustments may be made using this equipment (programmer). You will follow up with your physician in approximately 10 days for evaluation and removal of surgical clips. Further instructions will be provided to you then.
What are the risks?
The risks from the surgery to implant the pacemaker include:
- Bleeding
- Swelling or bruising under the skin
- Blood clot formation
- Infection
- Blood vessel damage
Your doctor will tell you about additional risks from the surgical procedure.
Is there anything that can interfere with the workings of my pacemaker?
Electromagnetic interference. Some devices in your surroundings may interfere with your cardiac pacemaker. Currently available pacemakers are more resistant to this problem than earlier models. Always carry your wallet ID card with you. Some medical equipment can interfere with your pacemaker. If you are visiting your doctor or dentist, tell him or her that you have a pacemaker BEFORE they do any testing or treatment. Some security devices in department stores may temporarily interfere with your pacemaker function or give you cardiac symptoms. A general rule of thumb is "Don't lean, don't linger" when moving through these devices. Welders and electric generators may interfere with your pacemaker function.
When should I call my doctor?
Call your doctor if you feel any of the symptoms you had before the pacemaker was implanted (dizziness, lightheadedness, lack of energy or fainting spells), your chest muscles twitch, you have a rapid or pounding heartbeat or shortness of breath, you feel pain around your pacemaker or you have a fever over 101.0° F, or other signs of infection.
Links to consumer information:
Pacemakers
American Heart Association
Pacemakers and Implantable Defibrillators
MedlinePlus Health Information
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