A pacemaker is a surgically implanted electronic device that sends small electrical impulses to the heart muscle to maintain a suitable heart rate or to stimulate the lower chambers of the heart (ventricles). It is mainly used to regulate cardiac arrhythmia, also in cases of syncope, congestive heart failure, and hypertrophic cardiomyopathy.
The actual pacing device contains a pulse generator, circuitry programmed to monitor heart rate and deliver stimulation, and a lithium iodide battery. Battery life ranges from seven to 15 years, depending on the number of leads and the energy consumed by the pacemaker. When a new battery is required, the unit can be exchanged in a simple outpatient procedure.
PROCEDURE
Under sedation, a small incision is given in upper chest, where the leads and pacemaker are inserted. The leads are then guided through vein into the heart with the help of fluoroscopy machine. The lead tip attaches to heart muscle at one end and to the pacemaker at the other end. The pacemaker is placed in a pocket created beneath the chest skin. The incision is then closed.
Types of pacemakers are –
- - Single chamber- Uses one lead in the upper or lower chamber of the heart.
- - Dual Chamber-Uses one lead in the upper and one in the lower chamber of the heart.
- - Bi ventricular- Uses 3 leads, one in right atrium and one each in both ventricles.
When the heart rate drops below the set rate or is irregular, the pacemaker generates (fires) an impulse that passes through the lead to the heart muscle. This causes the heart muscle to contract, creating a heartbeat. Pacemakers are programmed externally with a handheld electromagnetic device.
DURATION
The pacemaker implant procedure may last from 2 to 5 hours. Hospital stay of 1-5 days may be needed.
RECOVERY
Normal routine may be resumed in a week. Detailed instructions regarding do’s and dont’s would be explained by the specialist.
RISKS
- Internal bleeding
- Infection
- Hemorrhage
- Embolism