Pacemakers are devices that can be placed in your body, usually by surgery, to support the electrical system in your heart. They can stabilize abnormal heart rhythms and prevent problems that can disrupt or endanger your life.

In this post, Pritish Kumar Halder that the surgeon will attach the tip of the pacing lead to your heart and the other end of the lead is attached to the pacemaker box. Read below:

How do pacemakers work?

Your heart has its own electrical system, which tells your heart’s chambers when it’s their turn to squeeze. When your heart’s electrical system malfunctions, your heart’s chambers may squeeze in the wrong order or squeeze too weakly to provide enough blood to your body. Pacemakers use electrical impulses to correct these kinds of malfunctions.

Working function of pacemaker

What conditions do pacemakers treat?

Conditions that are treatable with a pacemaker include (but aren’t limited to):

  • Certain heart arrhythmias (malfunctions of your heart’s normal beating process).
  • Disruptions of your heart’s electrical system (such as heart blocks).
  • Heart failure.
  • History of heart attack.

What are the signs you need a pacemaker?

Talking to your healthcare provider about your concerns or symptoms is the first step to determining if you have health problems that can be treated with a pacemaker. Some of the symptoms you should tell your healthcare provider about include:

  • Chest pain (also known as angina).
  • Tachycardia: This is an unusually fast heartbeat (more than 100 beats per minute).
  • Bradycardia: This is an unusually slow heartbeat (fewer than 60 beats per minute).
  • Irregular heartbeat (arrhythmia): A heartbeat that skips beats or adds in extra beats.
  • Heart palpitations: This happens when you can feel your heartbeat in a way that’s unpleasant (it might feel like your heart is “flip-flopping” or pounding in your chest).
  • Shortness of breath, especially when you’re more active.
  • Unexplained dizziness or lightheadedness, nausea or fainting.
  • Unexplained confusion.
  • Swelling in your ankles, legs and abdomen.
  • Needing to urinate multiple times at night.

What are the different types of pacemakers?

Depending on the heart problem, a specific type of pacemaker — with anywhere from one to three wires (called leads) — may be used. Types of pacemakers include:

Leadless pacemaker: A small pacemaker (about the size of a large pill) inserted using a catheter-based procedure. This device is attached to an inner wall of your heart, which means it doesn’t need to use any wires.

Single-chamber pacemaker: Uses a single wire attached to one chamber of your heart.

Dual-chamber pacemaker: Uses two wires attached to two chambers of your heart.

Biventricular pacemaker: Uses three wires, two of which attach to the lower chambers (called ventricles) of your heart, and a third connected to the right upper chamber (the right atrium). This is also known as cardiac resynchronization therapy (CRT).

What’s the difference between a pacemaker and an ICD?

A pacemaker delivers electrical impulses to control the rhythm of your heart, but it can’t deliver a shock to correct an arrhythmia.

Most new implantable cardioverter defibrillators (ICDs) can do the same job as a pacemaker, as well as detect dangerous heart rhythms. Once these are detected, the ICD can deliver a shock to restore your heart back to its normal rhythm.

Procedure

Before the procedure

You’ll likely be awake during the surgery to implant the pacemaker, which typically takes a few hours. A specialist will insert an IV into your forearm or hand and give you a medication called a sedative to help you relax. Your chest is cleaned with special soap.

Most pacemaker implantations are done using local anesthesia to numb the area of the incisions. However, the amount of sedation needed for the procedure depends on your specific health conditions. You may be fully awake or lightly sedated, or you may be given general anesthesia (fully asleep).

During the procedure

One or more wires are inserted into a major vein under or near your collarbone and guided to your heart using X-ray images. One end of each wire is secured at the appropriate position in your heart, while the other end is attached to the pulse generator, which is usually implanted under the skin beneath your collarbone.

A leadless pacemaker is smaller and typically requires a less invasive surgery to implant the device. The pulse generator and other pacemaker parts are contained in a single capsule. The doctor inserts a flexible sheath (catheter) in a vein in the groin and then guides the single component pacemaker through the catheter to the proper position in the heart.

After the procedure

You’ll likely stay in the hospital for a day after having a pacemaker implanted. Your pacemaker will be programmed to fit your heart rhythm needs. You’ll need to arrange to have someone drive you home from the hospital.

Your doctor might recommend that you avoid vigorous exercise or heavy lifting for about a month. Avoid putting pressure on the area where the pacemaker was implanted. If you have pain in that area, ask your doctor about taking medicines available without a prescription, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Special precautions

It’s unlikely that your pacemaker would stop working properly because of electrical interference. Still, you’ll need to take a few precautions:

Cellphones. It’s safe to talk on a cellphone, but keep your cellphone at least 6 inches (15 centimeters) away from your pacemaker. Don’t keep your phone in a shirt pocket. When talking on your phone, hold it to the ear opposite the side where your pacemaker was implanted.

Security systems. Passing through an airport metal detector won’t interfere with your pacemaker. Although the metal in the pacemaker could sound the alarm. But avoid lingering near or leaning against a metal-detection system.

Medical equipment. Make sure all your doctors and dentists know you have a pacemaker. Certain medical procedures, such as magnetic resonance imaging, CT scans, cancer radiation treatment, electrocautery to control bleeding during surgery, and shock wave lithotripsy to break up large kidney stones or gallstones could interfere with your pacemaker.

Power-generating equipment. Stand at least 2 feet (61 centimeters) from welding equipment, high-voltage transformers or motor-generator systems. If you work around such equipment, ask your doctor about arranging a test in your workplace to determine whether the equipment affects your pacemaker.

Devices that are unlikely to interfere with your pacemaker include microwave ovens, televisions and remote controls, radios, toasters, electric blankets, electric shavers, and electric drills.

What are the possible complications or side effects of having a pacemaker?

Pacemaker procedures tend to have few complications, which you can discuss with your healthcare provider. In general, the following complications are possible:

Allergic reactions: These may happen because of a medication you’re given or you may be allergic to one of the materials used in the pacemaker itself.

Blood clots: Your healthcare provider may prescribe blood-thinning medications to reduce the risk of developing a blood clot.

Malfunctions of the pacemaker or its leads: In some cases, a pacemaker lead may get jostled out of position or might break free. Your healthcare provider will recommend limiting your activity for a while after your procedure to avoid this.

Malfunctions caused by sources outside of your body: Your healthcare provider will give you instructions on devices or machines to avoid so you don’t have pacemaker problems caused by outside electrical interference. Fortunately, advancements in pacemaker technology mean these situations aren’t common.

Unexpected heart rhythm problems: Some people develop heart rhythm problems — in rare instances — because of the pacemaker. Your healthcare provider can talk to you about these risks and help you avoid them.

Reference

https://www.mayoclinic.org/tests-procedures/pacemaker/about/pac-20384689

https://my.clevelandclinic.org/health/treatments/17360-permanent-pacemaker