Pacemaker

1 What is a Pacemaker?

A pacemaker is a small device used to help control abnormal heart rhythms like arrhythmias when the heart beats too fast, too slow or irregularly, tachycardia when a heartbeat is too fast and bradycardia when the heartbeat is too slow.

With each heart beat of a Normal human heart, an electrical signal spreads through the heart and it causes the heart to contract and pump blood. The first two upper chambers of the heart called the atria contract and the blood is pumped into two lower chambers called the ventricles which pump the blood to the rest of the body.

In patients with arrhythmias, the heart does not pump enough blood to the body and this can cause symptoms like shortness of breath, dry cough, swelling of the ankles or legs, weight gain, increased urination, fatigue, or rapid or irregular heartbeat. If the arrhythmias are severe, it can damage the body's vital organs and may even cause loss of consciousness or death.

The device is placed in the chest or abdomen and with low-energy electrical pulses, it prompts the heart to beat at a normal rate. A pacemaker can also monitor heart’s electrical activity and heart rhythm and newer one can also monitor blood temperature, breathe rate another factor.

Pacemakers can be temporary or permanent. Temporary pacemakers treat temporary heartbeat problems caused by a heart attack, heart surgery, or an overdose of medicine and permanent pacemakers are used to control long-term heart rhythm problems.

Before procedure a doctor will recommend few tests like:

  • Electrocardiogram (EKG) - shows how fast the heart beats and its rhythm
  • Holter monitor - records the heart's electrical activity for a full 24- or 48-hour period
  • Event monitor - records heart's electrical activity when sensing abnormal heart rhythms
  • Echocardiography - provides information about the size and shape of the heart and how well heart chambers and valves are working
  • Electrophysiology study - records the heart's electrical signals
  • Stress test - helps to diagnose when the heart is working hard and beating fast.

During pacemaker surgery, which takes a few hours, one or three wires with sensors called electrodes are placed in different chambers of the heart. They are connected with a computerized generator which is connected to the battery. The generator and the battery are placed in the box and slipped under the skin.

After surgery, usually, the patient can go home the next day after surgery. Patients may have pain, swelling, or tenderness in the area where the pacemaker was placed but the pain can be relieved with the pain medications.

It is important that the patient avoids extreme pulling or lifting motions (such as placing an arm overhead without bending at the elbow). Activities such as golf, tennis, and swimming should be avoided for 6 weeks from when the pacemaker was implanted.

Devices like cell phones, metal detectors, anti-theft devices and refrigerator door magnets have strong magnetic field and they can disrupt the electrical signal of pacemaker and stop it from working properly so a person must avoid close or prolonged contact this kind of devices.

Cell phone and the MP3 player must be held in the hand opposite the site where the pacemaker was implanted. A person can use household appliances but must avoid close and prolonged exposure, as it may interfere with the pacemaker.

A person with pacemaker must notify airport screeners, dentist, doctor and medical technicians. The doctor will give a patient a card that states what type of pacemaker does a person have and also the patient can consider wearing a medical ID bracelet or necklace that states that he/she is having a pacemaker.

The pacemaker will be checked and some functions of the pacemaker will be checked remotely through a telephone and some in doctor’s office every few months. Batteries will be replaced after 5 and 15 years, but the average is 6 to 7 years during small surgery.

The risks of pacemaker surgery are very low but may include blood vessel or nerve damage, a collapsed lung or a bad reaction to the medicine during the surgery.

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