1. Pacemakers Help Control the Heart Rate
Pacemakers are inserted to help regulate the heart’s electrical system. If the heart rate is too slow patients can experience dizziness, trouble breathing and can even black out; in extreme cases, their heart can stop. A pacemaker stimulates the upper or lower chamber to contract at a pre-specified rate. As patients age, the electrical conduction system can fail to generate the impulses move the pump fast enough. In some cases there is an alternation between too fast and too slow. Medications that are needed to prevent fast heart rates result in symptomatic slow heart rates.
2. Not All Pacemakers Are the Same
Most pacemakers are inserted into both the upper and lower chambers. In some patients only the upper chamber needs regulation, while others have intrinsic activity in the upper chamber but cannot send the signal to the lower chamber. If a patient has a history of heart attack or heart failure with poor heart function, the pacemaker might include a defibrillator to help protect the patient from sudden cardiac death from a lethal arrhythmia (ventricular tachycardia or fibrillation). There are even specialized pacemakers that can improve the function of a weakened heart by adding a third wire to help stimulate the left ventricular chamber (bi-ventricular pacemaker).
3. Surgery to Insert a Pacemaker Is Elaborate
A pacemaker is inserted by a surgeon or cardiologist by accessing the vein in the upper chest and placing the wires into the right heart chambers under X-ray guidance. A small generator is placed above the pectoral muscle and connected to the leads. The quality of the electrical signals is tested and optimized and the skin is closed over the generator. The longevity of the pacemaker will depend on the percentage of time it is used. Some patients can wait 8 to 10 years before replacing the generator, while others who use it 100 percent of the time will need a new generator in 5 years or less. In many cases the implant procedure can take less than an hour to complete.
4. Problems with Pacemakers
Most pacemakers never have problems, but rarely there can be issues with failure of the leads (wires) because of poor connections or fractures. Occasionally the pacemaker can overstimulate the heart and cause a rapid heart beat. In very rare cases pacemakers can become infected, requiring removal and placement of temporary devices along with the long-term infusion of antibiotics. During the implant procedure there is a rare chance that the heart or lung can be seriously injured during insertion.
5. Pacemakers Care Includes Testing
Routine follow-up for a pacemaker includes a visit shortly after implantation to confirm that the wires are working correctly and to make sure the incision over the skin is not infected. Routine testing of the device is done by the cardiologist or a representative from the company every 6 months. Most people never have any issue with their pacemaker other than the need for generator replacement. In fact, after a while most patients don’t even know that it is there or doing anything special, but without it they probably couldn’t even function on a day-to-day basis.
