A pacemaker is a small device that is surgically implanted in the thorax that uses electrical pulses to help control abnormal heart rhythms. Arrhythmias are problems that deal with the rhythm or rate of the heartbeat. During these arrhythmias, the heart beats too fast causing tachycardia, too slow which is bradycardia, or with irregular rhythm. Pacemakers treat arrhythmias.
During an arrhythmia, the heart may have a problem pumping enough blood throughout the body. This lack of blood flow can case symptoms such as shortness of breath, fatigue, or fainting. An extended period of this lack of blood flow, or a severe arrhythmia can damage vital organs throughout the body, and may cause loss of consciousness or death(https://www.nhlbi.nih.gov/health-topics/pacemakers).
So how does a Pacemaker work?
This device has a battery, a computerized generator, and wire with sensors at the tips. The battery powers the generator, while both parts are contained in a thin metal box. The wires connect the battery and generator to the heart. The wires are attached to the heart’s chambers and electrical impulses stimulate the heart to beat at a normal rhythm. The pacemaker’s computer also records the heart’s electrical activity and the hearts rhythm. These recordings help physicians adjust the pacemaker to work better for the patient and the physician can reprogram the device without physically touching it after it is implanted.
There are typically only a few variations of pacemakers. There is a single lead, or single chamber, double lead, or double chamber, or biventricular. Depending on what the patient needs, the physician assess what pacemaker would be best. After the pacemaker is inserted, the pacemaker typically is just loose within the patients upper chest (http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300451.pdf).
How is a pacemaker inserted?
A pacemaker implantation takes about one to three hours. A one to two inch incision is made to create a "pocket" in the skin underneath the collarbone where the generator sits. This insertion of the pacemaker is "performed in a cardiac catheterization laboratory under local or less common general anesthesia and is considered to be a minimally invasive procedure. Transvenous access to the heart chambers is the preferable technique, commonly via a percutaneous approach of the subclavian vein, the cephalic vein (cut-down technique), or rarely the axillary vein, the internal jugular vein or the femoral vein (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356861/)". After there is access to the vein, a guide wire is advanced through the vein and placed on the right atrium or the vena caval, with the navigation being guided under fluoroscopy. A second guide wire may be positioned, in necessary, by the same route or through a second vein route. After the leads a successfully placed, the guide wire is removed and tests for sensing are held. The lead is then sewn with a non-absorbable suture into the underling tissue, then the generator is placed into the pocket and connected to the lead. Lastly, the incision is closed with absorbable suture and an arm immobilizer is worn by the patient for 12-24 hours.
With a pacemaker, the patient must avoid close contact or prolonged contact with electrical devices or devices that have strong magnetic fields. The devices that have the potential to interfere with a pacemaker may include (but not necessarily limited to): Cell phones, MP3 players, Household appliances, such as microwave ovens, high-tension wires, metal detectors, industrial welders, or electrical generators. Patients with pacemakers are cautioned against exposure with these devices because these devices can disrupt the electrical signaling of the pacemaker and stop it from working properly. How likely a pacemaker disruption is to occur depends on how like the pacemaker is exposed to the device and the proximity of the device to the pacemaker.
Having a pacemaker will not limit the patient from many doing sports or exercise, including strenuous actions. Full contact sports, such as football, may need to be avoided by the patient. Such contact could have the potential to damage the pacemaker or shake loose the wires leading into the heart. Consulting a physician to discuss what kinds of physical activities are safe is recommended.
Care for the Pacemaker
Meeting with the patients attending physician multiple times to do checkups on the pacemaker is recommended. Due the pacemaker’s generator being powered by a battery, the pacemaker will need to be replaced. Pacemaker batteries last anywhere between 5 and 15 years, with the average being 6 to 7 years, depending on how active the pacemaker is. The pacemaker generator and battery would be replaced before the battery even starts to run down to keep the risk of a low battery low. Replacing the generator and battery is a much less involved surgery than the original surgery to implant the pacemaker. The pacemaker wires may also need to be replaced eventually(https://www.mayoclinic.org/tests-procedures/pacemaker/about/pac-20384689)
What is a pacemaker?
A pacemaker is a small device that is surgically implanted in the thorax that uses electrical pulses to help control abnormal heart rhythms. Arrhythmias are problems that deal with the rhythm or rate of the heartbeat. During these arrhythmias, the heart beats too fast causing tachycardia, too slow which is bradycardia, or with irregular rhythm. Pacemakers treat arrhythmias.
During an arrhythmia, the heart may have a problem pumping enough blood throughout the body. This lack of blood flow can case symptoms such as shortness of breath, fatigue, or fainting. An extended period of this lack of blood flow, or a severe arrhythmia can damage vital organs throughout the body, and may cause loss of consciousness or death(https://www.nhlbi.nih.gov/health-topics/pacemakers).
So how does a Pacemaker work?
This device has a battery, a computerized generator, and wire with sensors at the tips. The battery powers the generator, while both parts are contained in a thin metal box. The wires connect the battery and generator to the heart. The wires are attached to the heart’s chambers and electrical impulses stimulate the heart to beat at a normal rhythm. The pacemaker’s computer also records the heart’s electrical activity and the hearts rhythm. These recordings help physicians adjust the pacemaker to work better for the patient and the physician can reprogram the device without physically touching it after it is implanted.
There are typically only a few variations of pacemakers. There is a single lead, or single chamber, double lead, or double chamber, or biventricular. Depending on what the patient needs, the physician assess what pacemaker would be best. After the pacemaker is inserted, the pacemaker typically is just loose within the patients upper chest (http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300451.pdf).
How is a pacemaker inserted?
A pacemaker implantation takes about one to three hours. A one to two inch incision is made to create a "pocket" in the skin underneath the collarbone where the generator sits. This insertion of the pacemaker is "performed in a cardiac catheterization laboratory under local or less common general anesthesia and is considered to be a minimally invasive procedure. Transvenous access to the heart chambers is the preferable technique, commonly via a percutaneous approach of the subclavian vein, the cephalic vein (cut-down technique), or rarely the axillary vein, the internal jugular vein or the femoral vein (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356861/)". After there is access to the vein, a guide wire is advanced through the vein and placed on the right atrium or the vena caval, with the navigation being guided under fluoroscopy. A second guide wire may be positioned, in necessary, by the same route or through a second vein route. After the leads a successfully placed, the guide wire is removed and tests for sensing are held. The lead is then sewn with a non-absorbable suture into the underling tissue, then the generator is placed into the pocket and connected to the lead. Lastly, the incision is closed with absorbable suture and an arm immobilizer is worn by the patient for 12-24 hours.
(https://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/treatments/pacemaker.html).
How does a pacemaker affect a patient’s life?
With a pacemaker, the patient must avoid close contact or prolonged contact with electrical devices or devices that have strong magnetic fields. The devices that have the potential to interfere with a pacemaker may include (but not necessarily limited to): Cell phones, MP3 players, Household appliances, such as microwave ovens, high-tension wires, metal detectors, industrial welders, or electrical generators. Patients with pacemakers are cautioned against exposure with these devices because these devices can disrupt the electrical signaling of the pacemaker and stop it from working properly. How likely a pacemaker disruption is to occur depends on how like the pacemaker is exposed to the device and the proximity of the device to the pacemaker.
Having a pacemaker will not limit the patient from many doing sports or exercise, including strenuous actions. Full contact sports, such as football, may need to be avoided by the patient. Such contact could have the potential to damage the pacemaker or shake loose the wires leading into the heart. Consulting a physician to discuss what kinds of physical activities are safe is recommended.
Care for the Pacemaker
Meeting with the patients attending physician multiple times to do checkups on the pacemaker is recommended. Due the pacemaker’s generator being powered by a battery, the pacemaker will need to be replaced. Pacemaker batteries last anywhere between 5 and 15 years, with the average being 6 to 7 years, depending on how active the pacemaker is. The pacemaker generator and battery would be replaced before the battery even starts to run down to keep the risk of a low battery low. Replacing the generator and battery is a much less involved surgery than the original surgery to implant the pacemaker. The pacemaker wires may also need to be replaced eventually(https://www.mayoclinic.org/tests-procedures/pacemaker/about/pac-20384689)