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Pacemaker Implantation
What is a Pacemaker Implantation?
Your heart's electrical system is in control of maintaining a regular, steady rhythm. Any abnormal heart rhythm or disturbance in the normal cadence of the heartbeat is known as an arrhythmia. Pacemakers are used to prevent the heart from beating too slowly when you have a chronic slow or irregular heartbeat, a type of arrhythmia known as bradycardia. They can also help treat heart failure by ensuring normal heart function. Pacemakers consistently maintain a normal heart rate by sending electrical signals to your heart when they detect a slow or irregular heartbeat.
A pacemaker has two parts: a pulse generator and leads. The pulse generator controls when electrical pulses are sent to the heart, and the leads (electrodes), which are attached to the chambers of your heart, deliver the electric signals to restore a normal heart rate.
Risks & Benefits of a Pacemaker Implantation
Pacemaker implantation is a safe, effective way to manage arrhythmias and their complications when medications alone are insufficient. They can help prevent serious cardiovascular complications. Though there are some risks, these are uncommon when working with an experienced physician.
Benefits of Pacemaker Implantation
- Manages Irregular Heart Rhythms
Pacemakers can correct issues like bradycardia by regulating the heartbeat. - Prevents Serious Complications
Abnormal rhythms can lead to more serious issues like heart failure; a cardiac pacemaker can prevent this. - Improves Heart Function
Steady stimulation from the pacemaker can help the heart contract more efficiently and pump more blood. - Portable Monitoring
Pacemaker activity can be monitored remotely by clinicians to assess how it is working. - Non-Invasive Procedure
The surgery involves small incisions and placement of wires threaded through the veins, making it much less invasive than open heart surgery.
Risks of Pacemaker Implantation
- Bleeding, Bruising, or Swelling
- Collapsed Lung (Pneumothorax)
- Damage to Blood Vessels or Nerves
- Infection
- Movement of the Device
- Blood Clots
- Hemothorax
What to Expect Before, During, and After Pacemaker Implantation
Implanting a pacemaker typically takes a few hours. Before the procedure, we will administer an IV with a sedative so you can relax. We use conscious sedation for most pacemaker insertions; however, in certain cases, we may need to use general anesthesia, where you will be fully asleep.
Using a major vein near your collarbone, we will insert one or more wires and guide them to your heart with the help of X-ray images. For each wire, one end is inserted in the necessary area of your heart, while the other end attaches to the pulse generator, which we usually place beneath your collarbone.
A leadless pacemaker is smaller, with the pulse generator and leads contained in a single capsule. As such, this surgery is less invasive. We will use a vein in the groin to guide the pacemaker to the right position near the heart.
You will likely go home from the hospital the day after the procedure. You will need to have someone drive you home. Before you go home, we will program the pacemaker to suit your heart rhythm needs. Your doctor will discuss any precautions you need to take around things like cell phones or certain medical equipment.
Am I a Candidate for Pacemaker Implantation?
A pacemaker is most often recommended for people who have bradycardia, when the heart beats too slowly. In some cases, it may be used for people whose heart beats too fast (tachycardia) or to correct an arrhythmia. The symptoms and conditions that may indicate the need for a pacemaker include:
- Bradycardia
Patients with heart rates consistently lower than 60 bpm may benefit from a pacemaker to regulate rhythm. - Heart Block
Individuals with third-degree or complete heart block need a pacemaker to maintain normal conduction. - Arrhythmias
Pacemakers can provide relief for those experiencing significant symptoms from arrhythmias like atrial fibrillation. - Syncope
Fainting or near-fainting due to pauses in heart rhythm indicates pacemaker implantation. - Heart Failure
Some heart failure patients have conduction abnormalities that a pacemaker can help correct. - Congenital Defects
Certain congenital defects can disrupt the heart's electrical system for which a pacemaker is warranted. - Persistent Symptoms
Those with recurring dizziness, fatigue, or chest pain from rhythm disturbances may benefit from having a pacemaker. - Medications Not Working
When medications fail to adequately control rhythm problems, a pacemaker is often the solution.
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