Understanding Pacemakers

A pacemaker is a tiny medical device placed in the chest to help control the heart’s rhythm. It is mainly used to treat heart conditions such as when the heart beats too slowly (bradycardia), rapidly (tachycardia), or irregularly (arrhythmias). The device sends electrical impulses to the heart, ensuring it beats at a constant and normal rate.

Functions of a Pacemaker

The main function of a pacemaker is to ensure the heart beats in sync, particularly when the electrical signals that control heartbeats are malfunctioning. The device identifies the heart’s natural rhythm through electrodes and delivers electrical impulses when needed to correct an irregular heartbeat. These impulses encourage the heart to beat at a specific pace, enhancing blood flow and overall heart health.

The pacemaker sends small electrical signals through the leads to stimulate the heart when the heart rate is too slow (bradycardia).

Fast rhythms (tachycardia) can be regulated, and irregular beats can be corrected by some types of pacemakers designed that way.

Types of Pacemakers

The pacemaker choice depends on the patient’s type of heart problem and the required treatment.

Temporary Pacemakers

Purpose	When arrhythmias in hospitalised patients are expected to be temporary, they can be used temporarily or as a bridge until a permanent pacemaker can be implanted.
Placement	The external pulse generator is usually taped to the skin, or fixed to a belt or the patient’s bed.
Monitoring	Frequent monitoring and constant evaluations are needed in hospitalised patients to help identify any complications.

Permanent Pacemakers

Purpose	Implanted devices for long-term treatment of persistent or recurring arrhythmias that are not temporary.
Indications	Symptomatic bradyarrhythmia (slow heart rate). Prevention or termination of specific types of tachyarrhythmias (fast heart rate). Permanent pacing is recommended for conditions where it is beneficial or required based on particular guidelines.
Implantation	Certain medications (e.g., blood thinners) need to be stopped as told by the doctor. Usually conducted under local anaesthesia with conscious sedation.

Pacemaker with Leads

Pulse Generator:
1. Commonly inserted beneath the skin below the clavicle (prepectoral area).
2. Sometimes inserted in the upper abdomen.

Lead Placement:
1. Single-Chamber: One lead in the right atrium or right ventricle.
2. Dual-Chamber: One lead in both the right atrium and right ventricle.
3. Leads to enhance cardiac synchrony:
  1. Cardiac Resynchronisation Therapy (CRT):
    1. Uses three leads: right atrium, right ventricle, and a branch of the coronary sinus for the left ventricle.
    2. Improves the ventricular contractions’ coordination.
  2. Conduction System Pacing:
    1. Removes the need for a third lead by positioning the right ventricular lead to activate the heart's natural conduction system.

Leadless Pacemakers

Features:
1. Inserted right into the heart via a vein in the leg.
2. No leads are needed, decreasing complications linked to traditional leads.

Applications:
1. Normally single-chamber devices for the right ventricle.
2. Newer models provide dual-chamber pacing for both the right atrium and ventricle.

The Importance of a Pacemaker

A pacemaker is important in enhancing the quality of life for patients with heart rhythm issues. The device ensures the efficiency of the heart's electrical system functions, preventing complications such as heart failure, stroke, or sudden cardiac arrest. Pacemakers help prevent the requirement for more invasive procedures in many cases, providing patients with a safer and less risky treatment option.

Frequently Asked Questions about Pacemaker (FAQs)

1. Can I feel the pacemaker functioning?

No, you usually will not feel the pacemaker working. However, some individuals might notice a slight flutter or feeling at the initial stage, which normally subsides over time.

2. What is the lifespan of a pacemaker?

Depending on the pacemaker’s type, most last between 5 to 15 years. Frequent check-ups with a heart specialist will determine when the pacemaker needs a new battery.

3. Do I need any lifestyle changes after getting a pacemaker?

Patients after getting their pacemakers are normally advised to refrain from heavy lifting or vigorous physical activity for a couple of weeks. However, most individuals can go back to their normal activities after a short recovery time.

4. Can a pacemaker be removed?

A pacemaker in certain cases can be removed if it is not needed anymore or if complications appear. This is normally a rare occurrence and decisions related to its removal are made on a case-by-case basis with the heart specialist.

Schedule an Appointment at Gleneagles Hospitals

A pacemaker can significantly improve your quality of life if you have heart rhythm issues. If you or a loved one are going through symptoms such as dizziness, fainting, fatigue, or irregular heartbeats, it is important to consult a heart specialist immediately.

If you have concerns about your heart health or are considering a pacemaker, contact us to schedule an appointment at your nearest Gleneagles Hospital. The expert cardiology team is here to provide personalised advice and guidance on pacemaker treatment. You may also book an appointment by downloading the MyHealth360 application from the Google Play Store or Apple App Store.

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