The heart is an organ that is run by an internal electrical system that generates regular electrical pulses to coordinate the contractions of its chambers. For some people, this electrical system may malfunction, causing abnormal heart rhythms. This is where pacemakers come in.
These medical devices are implanted under the skin to regulate the heart’s rhythm. They are used to maintain a stable heart rhythm and prevent symptoms associated with an abnormally low heart rate, such as dizziness, fainting, and heart failure.
How does a pacemaker work?
It is made up of two main parts:
- The pulse generator: a small metal box containing a battery and electronic circuits that generate electrical pulses. This box is generally inserted under the skin, near the collarbone.
- Electrodes: thin leads that are threaded into the heart’s chambers through a vein, delivering electrical pulses from the generator to the heart. These leads can also detect the heart’s electrical activity and send this information to the pulse generator.
The pacemaker constantly monitors the rhythm of the patient’s heart. If it detects a heart rhythm that falls below an established threshold, it sends an electrical pulse through the leads to pace the heart and make it beat at an appropriate rate. This process is nearly imperceptible for the patient as the pacemaker runs in the background to maintain a stable and regular rhythm.
Modern pacemakers are often programmable and can be adjusted to meet each patient’s specific needs.
There are also pacemakers without leads.
Why get a pacemaker?
Pacemakers are recommended for patients whose heart rhythm is too slow or irregular as this can cause serious symptoms.
What are the different types of pacemakers?
Different patients will need different types of pacemakers to suit their unique needs:
- Single-chamber pacemakers have just one lead that is usually connected to the right ventricle.
- Dual-chamber pacemakers have two leads: one in the right atrium and one in the right ventricle. This configuration allows the pacemaker to synchronize the contractions of the atria and the ventricles, mimicking the natural rhythm of the heart. They are particularly effective for patients with conduction disorders affecting both the atria and ventricles.
- Triple-chamber pacemakers, also called cardiac resynchronization devices, are used for people with heart failure with desynchronization between the left and right ventricles. They have three leads: one in the right atrium, one in the right ventricle, and another in a vein along the left ventricle. This device synchronizes the contractions of the two ventricles, which enhances the heart’s ability to pump blood effectively.
What precautions should be taken?
Life with a pacemaker will require a few adjustments, but most patients are able to live a normal life after it is implanted.
They must be continuously monitored and have regular appointments with their cardiologist to ensure the pacemaker is working correctly. During these visits, the cardiologist will perform tests to ensure that the battery and device are functioning correctly. Many modern pacemakers feature remote monitoring capabilities allowing the cardiologist to monitor the pacemaker remotely.
Although pacemakers are designed to withstand many different types of interference, certain electrical devices and strong magnetic fields can interfere with their operation. We generally advise patients to:
- Keep mobile phones at a safe distance,
- Avoid scanners and MRIs,
- Use caution when passing through security gates.
Most patients can resume their regular physical activities. However, we recommend avoiding any activities involving a risk of direct trauma to the pacemaker implantation site. Sports like swimming, jogging, and walking are generally safe, but you should always talk to your physician about your sports activities.
Reviewed and approved by Lyric Institute’s cardiac pacing team
