All You Need to Know about Pacemakers

A pacemaker is an electronic device that helps control and regulate the heart rhythm. It consists of:

  • A computer with electrical circuits that restores the normal heart beat
  • A battery that provides power to the computer
  • Wires that connect the computer to the heart.

The device is covered with a thin metal box, out of which extend leads with sensors at their tips.

A pacemaker uses electrical impulses to make the heart beat at a normal rate. It is generally employed to overcome faulty electrical impulses in the heart that make the heart rate to become too slow and irregular – a condition known as bradycardia.

Other conditions that have to do with the heart’s electrical conduction system and which require a pacemaker are:

  • Sick sinus syndrome – when the heart’s own pacemaker – sinus node – stops working properly
  • Heart block – when there is a delay in the electrical impulses travelling between the ventricles and the atria
  • Atrial fibrillation – when too slow heartbeat originates in the atria
  • Cardio-inhibitory syncope – when there is a pause of a few seconds in the heart rhythm
  • Heart failure – when the ventricles don’t pump in time with each other, causing symptoms of breathlessness and extreme tiredness.

While the heart beats, the sensors detect its electrical activity and send data through the wires to the computer in the pacemaker. If the heart beats normally, then the pacemaker simply monitors the beats. If the heart beats too fast, too slow or irregularly, the computer sends out electrical signals to regulate heart rate.

A pacemaker can be temporal and permanent. Temporary devices may be needed just shortly after having a heart attack, heart surgery or drug overdose. Permanent pacemakers are necessary to control long-term heart defects and needed for the rest of the life to help manage ongoing heart disease.

Pacemakers are implanted under the skin in the chest or abdomen area under topical anesthesia. The patient receives medicine to relax and numb the implant area. Then a needle is placed into a large vein and the leads are thread through it into the heart. After that a small cut in the skin is made and the pacemaker box is placed under the skin. Finally, the wires are connected to the box and the cut is sewed up. The procedure takes about 1 or 2 hours and the patient stays in the hospital overnight for the doctors to make sure the device is working well.

The patient may experience pain, swelling or tenderness in the area the pacemaker is placed, which can be relieved by pain killers. Most patients can return to their normal activities in a few days of having a surgery, but they are warned to avoid vigorous activities and weight lifting for a month after the implantation.

It is necessary to have your pacemaker checked every 3 to 6 months to be sure it works well. The batteries typically last for 5-8 years, so ask your doctor when to replace them. You also should:

  • Keep your pacemaker ID card with you all the time.
  • Always inform your health care providers that you have a pacemaker, since some medical equipment can affect its performance.
  • Always let the security know that you have a pacemaker when going through a security check point at an airport or elsewhere.
  • When talking on cell or cordless phone, hold it to the ear on the opposite side to your pacemaker. Never carry your phone in the chest pocket of your coat or shirt.
  • If you use an induction hob for cooking, keep a distance of at least 60 centimeters from your pacemaker, as the hob generates an electromagnetic field that may interfere with the pacemaker settings.
  • Inquire your pacemaker manufacturer or clinic whether you can use electrical shavers.

To get detailed instructions about which things to avoid, contact your pacemaker clinic.