Why would a patient need a Pacemaker?

• Slow heartbeat
• Irregular heartbeat (arrhythmia)
• Block in heart’s electrical pathway

What is a Pacemaker?
A pacemaker is a small, lightweight battery-powered device that helps the heart beat at a regular rhythm. It is used to replace a defective natural pacemaker or a blocked conduction path that prevents the electrical signal from reaching the heart muscle normally. It does this with a tiny, imperceptible electric impulse that helps control the beat.

There are two types of pacemakers, permanent (internal) and temporary (external).

• Pacemakers use batteries to send electrical impulses to the heart and so help it pump properly. An electrode is placed next to the heart wall, and the pacemaker transmits small electrical impulses that reach the electrode through a wire and make the heart contract.
• Most pacemakers have a sensor device that deactivates the pacemaker when the natural heartbeats are over a certain level. It is activated again when the beats are too slow. This is known as a demand pacemaker.

A pacemaker has two parts: a battery-powered generator and wires (leads) that connect it to the heart. If a patient needs a pacemaker for a short time, perhaps after a heart attack, the battery unit can be worn on a belt.

Why are pacemakers important?
Slow heart rhythms may cause symptoms such as lightheadedness, fainting spells, and tiredness.

A pacemaker gives the heart the extra help it needs to relieve symptoms and can help you feel better. Also, having a pacemaker can give you more freedom to do the activities you enjoy.

How does a pacemaker work?
A pacemaker has two main functions. It keeps track of the heart’s natural electrical activity (this is called sensing). It also sends electrical impulses to the heart to make the heart beat (this is called pacing).

For example, if the pacemaker senses that the heart is beating too slowly or pausing for too long, it sends tiny electrical impulses. These impulses are too slight for you to feel, but they stimulate the heart muscle to contract and pump blood.

If the pacemaker senses that the heart is beating at a proper pace, it goes “on demand” and stands by until it is needed. The instant the heart starts beating too slowly or pauses for too long, the pacemaker will begin pacing again.

The pacemaker’s sensing and pacing functions are adjusted, or “programmed,” by your doctor to meet your particular needs.

Pacemaker Implantation
An incision is made in the skin under the collar bone. The wires are threaded through the large vein under the clavicle that goes to the heart and wires are then hooked to the heart. The generator is then placed under the skin, is connected to the wires and held in place with a suture. The implantation procedure requires local anesthesia and takes about an hour.

The generator normally has a useful life of seven to twelve years.
Many people with pacemakers today lead full, active lives.

Click on Implanting Your Pacemaker for more info.

When can a pacemaker help?

• The decision on whether you need a pacemaker will depend on the type of arrhythmia you have, how severe your symptoms are, and whether you have other problems with your heart.
• Your doctor may recommend a pacemaker if you have one or more the following conditions:
• Bradycardia with significant symptoms, such as dizziness, fainting spells, tiredness, confusion, or shortness of breath
• Bradycardia with a very slow heart rate or long pauses between beats, even without symptoms
• Arrhythmias where the heart alternates between beating too fast and too slowly
• Arrhythmias and other medical conditions that require medications that cause bradycardia
• Recurring syncope (fainting spells) that is caused, at least in part, by significant slowing of the heartbeat
• Severe bradycardia caused by heart surgery or catheter ablation

Caring for your Pacemaker
It is important that you have follow-up visits with your doctor or pacemaker clinic. Your pacemaker may also be checked through telephone monitoring. In some cases, your pacemaker may need to be replaced.

Click on Caring for your Pacemaker for more info.

Living with a Pacemaker
Your pacemaker will help you feel better by relieving symptoms caused by a slow heart rhythm. Having a pacemaker may also give you more freedom to do the things you enjoy.
However, there are a few things you need to be aware of, so that your pacemaker works properly.

Click on Living with a Pacemaker for more info.

Your doctor will decide if you need a pacemaker, and if so, he or she will explain the reasons to you.

Other Electrophysiology services that we provide include:

Arrhythmia Evaluation

Event Recording

Holter Monitoring

Defibrillator Implantation & Monitoring

CRT Device

Implantable Loop Recorders

Arrhythmia Interventions & Ablations