Pacemaker

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A pacemaker is a miniaturized computer that sends electrical stimulation to the heart whenever it senses that the heart is not beating or is beating too slowly. Newer pacemakers also treat heart failure by resynchronizing the electrical impulses in the heart’s four chambers and improving its ability to pump blood to the body.


A pacemaker is an implantable device that is about the size of a couple of stacked silver dollars and weighs approximately 17-25 grams.

While the device is helping your heart maintain its rhythm, it also is storing information that can be retrieved by your doctor and used to program your pacemaker for the best possible therapy.

 

How It Works

A pacemaker has two components:

  • Pulse generator
  • Pacemaker leads

The pulse generator contains the battery and electronic circuitry that sends electrical pulses to the heart. This stimulates the heart and causes it to beat at a normal rhythm. The electrical impulses are very tiny.

The pacemaker leads are thin wires that are inserted through a vein and connect the generator to the heart. The leads pick up your own heart rhythm and transmit this information to the generator, which adapts its response to your needs.

 Photo of a Pacemaker: Pacemakers provide electrical stimulation when the heart does not beat or beats too slowly.

A programmer is an external tabletop computer that your doctor uses to change the pacemaker settings and download data stored in the pacemaker. Your doctor can adjust the therapy based on your needs over time without the need for further surgery.

Implanting the Pacemaker

Usually, your doctor will give you medication to help you relax, but you will still be aware of your surroundings and will be able to hear and even talk with the medical team during the procedure. Numbing medication will be given where the incision is made. You may, however, feel some pressure while the device is being implanted but you will not feel pain.

The procedure to place a pacemaker typically follows these steps:

  • Your doctor makes a small cut in the upper chest and locates a vein.
  • A small puncture is made in the vein and the leads are guided down the vein to the heart.
  • The surgical team monitors the lead placement using a large overhead monitor called a fluoroscope.
  • Once the leads are in place, your doctor tests them to make sure they are in the best position to deliver energy to the heart.
  • Your doctor might ask you to go through some simple maneuvers, such as taking a deep breath or coughing vigorously, to make sure the lead is stable.
  • Your doctor makes a “pocket” by separating the skin and underlying tissue form the muscle beneath the tissue.
  • The pulse generator is connected to the leads and placed in the pocket.
  • The incision is closed.

The length of the surgery depends on what kind of device you are getting, as well as your specific anatomy and the time it takes to locate a good position for the lead. Implanting a pacemaker can take a number of hours.

Benefits and Risks

By regulating your heartbeat, your pacemaker has the potential to help you live a longer, more productive and healthy life. With your pacemaker, you may be able to do all of the things you used to do—and possibly more.

As with any surgery, there are risks involved with having a pacemaker implanted. Your doctor is the best source of information about risks. A small percentage of patients may develop complications from the implant surgery, including bleeding, infection, lead dislodgement. Lead or pacemaker problems also can occur following surgery. Generally, risks depend on age, general health, specific medical condition and heart function. Talk to your doctor to better understand your potential benefits and risks.

See Important Safety Information for additional information.

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Animations

    Recommended animations:
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  • Preparing for Your Procedure: Pacemaker and ICD Placement

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Last Reviewed: March 11, 2010 900245