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Pacemakers are necessary to treat patients whose heart beats too slowly. A pacemaker is a small battery-operated device that helps your heart beat normally. The pacemaker resets the heart rate to an appropriate rate, ensuring adequate blood and oxygen reach the brain and other parts of the body.
A pacemaker contains a powerful battery, electronic circuits, and computer memory that together generate electronic signals. The signals, or pacing pulses, carry along thin, insulated wires, or leads. The signals cause the heart muscle to begin the contractions that cause a heartbeat.
The pacemaker is programmed to stimulate the heart at a pre-determined rate, and settings can be adjusted at any time. Routine evaluation, sometimes via telephone or internet, ensures the pacemaker is working properly and monitors battery life, which generally runs from eight to ten years.
A permanent pacemaker insertion is a minor surgery and can be done on an inpatient or outpatient basis. Doctors may perform the procedure in an electrophysiology laboratory, or cardiac catheterization lab.
The patient is given a local anesthetic, and the insertion site is cleaned and shaven. In most cases, the pacemaker is inserted beneath the skin on the front of the chest under the clavicle (collarbone). The physician will incise the chest wall just below the clavicle to create a small pocket, into which he or she places the pacemaker. Wires attached to the pacemaker (pacemaker leads) are then passed through a vein in the upper chest and directed to the right atrium or right ventricle. The leads, which stimulate the contractions of the heart, then attach to the inner surface of the heart chamber using small screws or tines. Following insertion, the skin is closed with sutures or staples. A chest x-ray is done to check position. Most patients go home the same day.
It is very important that you shower every day with soap and water prior to this procedure. Devices that are implanted require routine follow-up visits in your doctor's office to ensure they work properly. Compliance with these and all recommended appointments is critically important.
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