A cardiac pacemaker is an electronic device designed to monitor the heart's rhythm, and deliver a pulse to the heart at a programmed rate. This will assist your heart to maintain a healthy rhythm when your own heart rate is too slow or irregular.
Pacemakers are mainly used to treat slow heart rhythms and atrial fibrillation.
How do they work?
A pacemaker consists of two main parts:
The pulse generator, which produces the pacing pulses. It is powered by a small, sealed battery. The battery cannot be re-charged and the pulse generator must be replaced when the energy levels are depleted.
The lead or leads, which deliver the pacing impulses to the heart and monitor you heart's activity, relaying this information back to the pacemaker. The pacing wire (lead) is a narrow insulated conducting wire generally placed in the right atrium, the right ventricle or both.
How the heart beats
See Normal electrical activity of the heart
Why is a pacemaker needed?
The sinus node may develop an abnormal rate (too slow or too fast) or fail to trigger an impulse. The normal pathway through the ventricles becomes blocked or interrupted. Another part of the heart tries to take over as the natural pacemaker, producing abnormal or extra beats.
This may cause the heart to beat very slowly or very fast, or fast then slow. If the heart does not beat as it should, the body may not get the oxygen it needs to function at an optimal level - you may feel tired, dizzy, light headed, short of breath or experience chest pain.
A pacemaker may be recommended.
Implanting a pacemaker
Putting in a pacemaker is a relatively short procedure (normally less than an hour). It can be done under a local or general anaesthetic, depending on the need.
The pacemaker lead is carefully inserted through a vein into your heart, using x-ray monitoring to ensure correct placement of the lead. The pacemaker is implanted just under the skin below the collar bone. The device and lead are checked before closure.
Living with a pacemaker
Generally at 4–6 weeks you should gradually be able to return to your normal routine such as:
- driving – after 2 weeks
- swimming, walking
- sports such as golf, tennis
- household activities such as cleaning, gardening and mowing lawns
- return to work – depending on the sort of work you do you may be able to resume earlier, after consulting your doctor
- other physical activities you were involved in.
Precautions
Electrical appliances
A pacemaker is protected from the electrical interference of everyday devices such as toasters, washing machines, hair dryers, electrical shavers, microwave ovens, television sets, radios and open bar radiators.
If you expect to come in contact with electrical equipment including electric welding gear or other equipment generating a strong magnetic field, discuss this with your specialist. If you some unusual sensations (rapid heart beat or feeling light-headed) when near some equipment step away or switch it off immediately.
Travel
When travelling by air, you will encounter the metal detector gates at check-in. Tell the security or customs personnel that you have a pacemaker and show them your pacemaker ID card before attempting to go through. This will avoid any problems for you.
Always carry your pacemaker identification card with you wherever you go.
