What is a pacemaker?
A pacemaker is a device that treats a slow heart rhythm. The pacemaker is the size of a matchbox and contains an electric circuit and battery. The pacemaker is usually inserted under the skin just below your collarbone and gives electric impulses through one or more leads that run down a vein to your heart (see figure 1).
What causes an abnormal heart rhythm?
The pumping of your heart (heartbeat) is controlled by electric impulses from a group of cells on your heart called the sinus node. When your heart beats normally, the electric impulses cause the upper collecting chambers (atria) and lower pumping chambers (ventricles) to contract and relax in a co-ordinated way.
A pacemaker is usually recommended to treat bradycardia, where the ventricles beat much more slowly than they should so not enough blood gets pumped.
What are the benefits of a pacemaker?
You may be at risk of developing an abnormal heart rhythm or you may have had an abnormal heart rhythm.
Serious bradycardia can cause cardiac arrest (where your heart stops working) and even death. Other symptoms include dizziness or collapsing (blacking out), feeling breathless or getting swollen legs.
A pacemaker is designed to sense if your heartbeat is too slow, and to give short electric impulses or paced beats to stimulate your heart to beat (pacing).
Are there any alternatives to a pacemaker?
Sometimes changes to your medication can help with a slow heartbeat.
Some symptoms of an abnormal heart rhythm can be treated using medication, but medication may not be as effective as a pacemaker.
What does the procedure involve?
Inserting a pacemaker usually takes between 30 minutes to an hour.
If appropriate, your heart specialist may offer you a sedative or painkiller.
Your heart specialist will make a cut just below your collarbone and pass a lead down a vein to your heart. If you need more than one lead, your heart specialist will repeat this procedure. They will create a pocket under the skin just below your collarbone to insert the pacemaker in.
What complications can happen?
- Pain or discomfort
- Bruising
- Bleeding
- Pneumothorax
- Blood leaking into the sac that surrounds your heart
- Infection of the wound
- A lead moving out of place
- The pacemaker developing a fault
- The pacemaker battery showing through your skin
- Developing a blood clot
- Allergic reaction to the equipment, materials or medication
- Radiation exposure
How soon will I recover?
You should be able to go home the same day or the day after.
Do not have a hot bath for two to three days. Keep your wound dry for the first week.
It is important not to do strenuous exercise for about a week, particularly exercise that involves you moving your shoulder. Do not have sex until you have recovered, usually after two to four weeks.
There is a risk that electro-magnetic fields could interfere with the pacemaker so you should not carry or use a mobile phone or digital device such as an iPod within 15 centimetres (6 inches) of the pacemaker. When going through security at airports, make staff aware that you have a pacemaker.
You do not need to take any precautions with everyday household appliances.
Your heart specialist will tell you when you can drive again.
The type of work you can do may also be affected, particularly if your job involves operating machinery.
Regular exercise should improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.
You will continue to have regular check-ups, usually every six months.
Acknowledgements
Author: Dr Julia Baron MD FRCP BMBS
Illustrations: Medical Illustration Copyright © 2012 Nucleus Medical Art. All rights reserved. www.nucleusinc.com
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EIDO Healthcare Ltd
Last updated:
June 2015
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