What is a pacemaker?
A pacemaker is an artificial device that is implanted in the chest to regulate an abnormal heart beat. The pacemaker consists of a battery which can last around 8-10 years depending on how much the device is used, a pulse generator that generates the electrical impulses to stimulate the heart and leads which carry the electrical impulses to the correct chambers of the heart. The pacemaker continually senses the heart beat and if it senses that your heart has missed a beat or is beating too slowly, it sends signals at a steady rate to stimulate the heart. If, however the pacemaker sense that the heart is beating normally, it does not need to stimulate the heart. Pacemakers also have a special sensor that recognises body movement or your breathing rate and allows the device to pace the heart faster during periods of increased demand.
What are the reasons for needing a pacemaker?
The most common reason for requiring a pacemaker is a slow heart beat usually heart block which can cause symptoms of dizzy spells, blackouts, tiredness or breathlessness. Pacemakers greatly improve the quality of life of patients that have them implanted. A slow heart beat can arise due to a problem with the heart being able to initiate the heart beat in the first place, or due to a failure of the top chambers of the heart to communicate with the bottom chambers (heart block) or for the electrical impulses generated to fail to conduct and pass along the heart’s own wiring system.
In some patients who have fast and uncontrollable heart beats, a pacemaker may be required in combination with medication. The experts at the One Heart Clinic are highly trained to assess all patients who may need a pacemaker and highly experienced in implanting devices to improve the quality of life of all patients.
How is a pacemaker implanted?
The implantation of a pacemaker is a relatively low risk and straightforward procedure. It is the most common type of heart surgery in the UK. The procedure is usually performed under local anaesthetic and conscious sedation. The pacemaker leads (flexible wires) are advanced to the heart through a large vein under the collarbone and carefully positioned into the correct chambers of the heart with the aid of X-rays and firmly secured into place. The leads are then connected to the pacemaker device which is usually smaller than the size of a small matchbox, and then placed in a small pocket just under the skin.
The wound, which is usually only 5cm long, is carefully sutured and patients can be discharged usually the same day. Pacemakers are checked using programmers which communicate with the devices and allow the doctor and technicians to adjust the device settings to optimise the performance of the pacemaker. Most patients can return to normal activities within 4 weeks of the implant and will require regular ongoing follow up and pacemaker checks to ensure correct functioning of the pacemaker. Although, pacemaker implantation is straightforward there is a low rate of risks related to the procedure including bruising at the site of the wound, infection or movement of the leads after insertion which may require further surgery to reposition and correct this.