A pacemaker is a small implanted device designed to address abnormal heart rhythms known as arrhythmias, specifically targeting slow rhythms called bradycardia. It is typically effective in alleviating symptoms such as shortness of breath, fatigue, and dizziness associated with bradycardia.

Arrhythmias arise from an issue in the heart's electrical system. Electrical signals follow a specific path through the heart, leading to its contractions. However, during bradycardia, there is a deficiency of these signals. For a deeper understanding of your heart's electrical system, refer to the Heart & Blood Vessel Basics section.

The pacemaker serves to reinstate a regular rhythm to your heart. Moreover, it can adapt to your body's requirements. This adaptability arises from sensors within the device that are capable of detecting:

• When you rest and need a slow heart rate
• When you exercise and need a faster heart rate

In many instances, your heart naturally maintains a regular rhythm effectively. A pacemaker is employed as a secondary treatment, stepping in only when necessary.

However, there are cases where the heart loses its ability to generate its own electrical signals or guide them along the correct pathways. This could be due to factors like aging or a specific ablation procedure. In such scenarios, pacemaker therapy becomes essential to ensure a consistent heartbeat.

The pacemaker functions by administering controlled electrical signals to the heart. This is achieved through the delivery of minute amounts of electrical energy (so subtle it's imperceptible) to either the upper or lower chambers of the heart, or sometimes to both.

Implanting the device is a procedure carried out under local anesthesia, typically not requiring general anesthesia.

Routine checks of the implanted device are imperative for reviewing the stored information and monitoring its settings.

How is the implant procedure done?

A pacemaker system comprises two main components:

1. Device : This is a compact unit, easily cradled in the palm of your hand. It houses miniature computerized components powered by a battery.

2. Leads : These are slender, insulated wires that establish a connection between the device and your heart. They facilitate the transmission of electrical signals to and from your heart and the device.

The insertion of leads is carried out by your doctor through a small incision, typically near your collarbone. Guided by fluoroscopy, a real-time X-ray imaging technique, your doctor gently navigates the leads through your blood vessels and into your heart.

Following this, the leads are attached to the device, and a series of tests ensure their seamless coordination in delivering treatment. Finally, the device is positioned just beneath your skin, and the incision is sutured closed.

What can I expect?

Before the procedure, you're usually advised to abstain from food or drink for a set number of hours. Upon arrival, you change into a hospital gown or wrap yourself in a sheet. The procedure takes place in a specialized room known as the "cath lab." You recline on an examination table, and a slender tube, called an intravenous (IV) line, is inserted into your arm. This IV administers fluids and medications throughout the procedure, inducing a drowsy state without rendering you unconscious.

The doctor creates a small incision near your collarbone to introduce the leads. This area is anesthetized, so any pain is minimal, though you might feel some pressure as the leads are put in place. A hospital stay overnight is typical, and you might experience some tenderness at the incision site. Recovery for most individuals is generally swift.