Cardiac Pacemaker:

What Is a Pacemaker?

Cardiac pacemakers are actually mini-generators, consisting of a programmable computer, a battery and a connector. One or two pacing leads (insulated wires with a small electrode on the tip) are inserted into the right side of your heart, either in the upper chamber (atrium) or in the lower chamber (ventricle). The leads carry signals to and from the heart. When the heart receives a signal, it contracts (beats). There are several types of pacemakers and your cardiologists and/or physician will decide which one suits your needs.

A problem in the electrical pathway of your heart can affect its ability to beat regularly. This can be corrected with implantation of an artificial cardiac pacemaker - a small, battery -operated device - which can control the heart's electrical system. A pacemaker weighs about an ounce. It contains a powerful battery, electronic circuits and computer memory, all of which work together to generate electronic signals. These are carried along thin, insulated wires, or leads, to the heart muscle. They cause the heart muscle to begin the contractions that cause a heartbeat.

A heart pacemaker is implanted just below the collarbone in a minor surgical procedure that takes about two hours. It is programmed to stimulate the heart at a pre-determined rate, and settings can be adjusted at any time. Routine evaluation, sometimes even via telephone, ensures the pacemaker is working properly and monitors battery life, which generally runs from five to ten years.

What Conditions are Cardiac Pacemakers Used For?

Pacemakers may be prescribed for a number of heart conditions, including:

Bradycardia - a condition in which the heart beats too slowly, causing symptoms such as fatigue, dizziness or fainting spells. Bradycardia may be caused by the wear and tear of age or by conditions such as sick sinus syndrome (SSS) or heart block.

Atrial fibrillation - a common heart rhythm disorder in which the upper chambers of the heart beat rapidly and chaotically. Sometimes people with atrial fibrillation can also have slow rhythms. Medicines used to control atrial fibrillation may result in slow rhythms which are treated by pacemakers.

Heart failure - a condition in which the heartbeat is not sufficient to supply a normal volume of blood and oxygen to the brain and other parts of the body. A special pacemaker can be carefully programmed to increase the force of muscle contractions in the heart. This is called "biventricular pacing" or "resynchronization" therapy.

Syncope - a condition best known as the common faint, is usually not serious. Some patients faint when their heart rhythm becomes very slow. For a small percentage of people who experience severe and frequent fainting spells, a pacemaker may prevent the heart rate from slowing to the point of fainting.

There are four basic types of pacemakers:

Single-Chamber Pacemakers - In a single-chamber pacemaker, only one wire (pacing lead) is placed into a chamber of the heart. Sometimes it is the upper chamber, or atrium. Other times it is the lower chamber, or ventricle.

Dual-Chamber Pacemakers - In dual chamber pacemakers, wires are placed in two chambers of the heart. One lead paces the atrium and one paces the ventricle. This approach more closely matches the natural pacing of the heart. This type of pacemaker can coordinate function between the atria and ventricles.

Rate-Responsive Pacemakers - These pacemakers have sensors that automatically adjust to changes in a person's physical activity.

Biventricular Pacemaker - An electronic, battery-powered device that is surgically implanted under the skin, a biventricular pacemaker (CRT) is used to treat the delay in heart ventricle contractions that occur in some people with advanced heart failure or cardiomyopathy.

Other devices - Some devices, such as implantable cardioverter defibrillators (ICDs), designed primarily for other purposes, can function as pacemakers in certain situations.

How Do I Prepare for Cardiac Pacemaker Insertion Surgery?

• Do not eat or drink anything for at least six hours before the pacemaker insertion procedure.
• Discuss your medications with your cardiologist/physician beforehand and follow his or her advice on whether you should stop taking them for a few days before the pacemaker procedure. Refrain from using aspirin for a few days as well. You may take approved medications with small sips of water.

If you are having a cardiac pacemaker procedure you will be contacted prior to the procedure by a member of the team who will give you detailed instructions on how to prepare.

Learn more about pacemakers.    » Go

For more information or to make an appointment please call 1-203-276-4777.

For more information or to make an appointment please call
1-877-233-WELL (9355).