Pacemaker
- Article
- 2021-02-18
A pacemaker is a small device used to treat certain arrhythmias. During an arrhythmia, the heart may beat too fast, too slow, or with an irregular rhythm. Pacemakers send electrical pulses to keep your heart beating at a normal pace and rhythm. Pacemakers can also be used to keep your heart chambers beating in sync so that your heart can pump blood to your body more efficiently. This may be necessary if you have heart failure.
You may need a temporary (short term) or permanent (long term) pacemaker. A temporary pacemaker is normally inserted through a vein in the neck and stays outside your body. A permanent pacemaker is placed in your chest or abdomen. This topic focuses on permanent pacemakers.
To get a pacemaker, you may need to stay in the hospital for a few hours or overnight. Once you are home, your doctor can remotely monitor your pacemaker and schedule regular visits with you to monitor its activity.
Many people with pacemakers can return to their normal activities within a few days. You may need to avoid certain electrical appliances or devices with strong magnetic fields.
To learn more about pacemakers, our role in research and clinical trials, and where to find more information, check out this health topic.
How Pacemakers Work
Pacemakers use low-energy electrical pulses to control the speed and rhythm of your heartbeat. Traditional pacemakers send the electrical pulses through wires, also called leads. Wireless pacemakers are a newer type of pacemaker without cables.
Learn more about your heart's electrical system in our health topic How the Heart Works.
Traditional transvenous pacemakers
Traditional pacemakers (also called transvenous pacemakers) consist of three main parts.
- A pulse generator provides the electrical pulses.
- Wires (also called leads) are implanted in the veins and carry the pulses to your heart.
- Electrodes sense your natural heartbeat. When your heart rate is slower than normal, the electrodes deliver electrical impulses to your heart to make it beat normally.
The device can remotely send data to your doctor. Your doctor will use these recordings to set up your pacemaker so that it works better for you.
A traditional pacemaker generator is placed outside your heart, in your chest or abdomen. It is connected by wires to electrodes in one to three heart chambers.
Single and dual lead pacemakers send pulses to the right side of the heart. A biventricular pacemaker sends pulses to both ventricles and an atrium. The pulses help coordinate electrical signals between the two ventricles to help your heart pump blood. This type of pacemaker is also known as a heart resynchronization therapy (CRT) device.
Wireless pacemakers
Wireless or cordless pacemakers are smaller than traditional types (about the size of a large pill). The pulse generator and electrodes are all contained in one device that is placed in a chamber of your heart through a tube inserted into one of your veins. No surgery is required. Once in place, the pacemaker sends pulses to the right ventricle.
Your doctor may recommend a wireless pacemaker if you have a slow heart rate or if you have an electrical block, that is, when the flow of electricity to the heart is slowed between the upper and lower chambers of your heart. Depending on its type, this type of pacemaker can detect the right atrium (upper chamber), allowing it to tune the signals it sends to the ventricle. This helps the two chambers beat in sync.
Other types
In another type of pacemaker, the electrodes are placed on the surface of your heart instead of in your heart. This type of pacemaker requires surgery.
Read more about the different types of pacemakers in How is a pacemaker placed?
Doctors also treat life-threatening arrhythmias with a similar device called an implantable cardioverter defibrillator (ICD). The device constantly monitors your heart rate. If your heart has an irregular and very fast rhythm, the ICD will deliver an electric shock to reset your heart rhythm to prevent sudden cardiac arrest.come. Visit our defibrillator health topic for more information.
Who Needs a Pacemaker? Pacemakers
Pacemakers are used to treat certain types of arrhythmias, as well as heart failure, a condition that occurs when the heart does not pump enough blood to the body. Not everyone with an arrhythmia needs a pacemaker.
Pacemaker for arrhythmias
The most common reason people get pacemakers is because their heart beats too slowly (called bradycardia), or it pauses, causing fainting or other symptoms. In some cases, the pacemaker can also be used to prevent or treat a too fast (tachycardia) or irregular heartbeat. These problems can be caused by:
- Problems with electrical signals in your heart. Read more in our health topic Conduction Disorder.
- Beta-blockers, which are drugs that lower blood pressure, but can also slow your heart rate too much. A pacemaker will help prevent a slow heart rate when you have to keep taking this medicine.
- Certain congenital heart disease s
- Heart attack
- Heart transplant
Pacemakers for the faint of heart
Pacemakers can also be used to keep your heart chambers beating in sync when your heart is not pumping enough blood to your body. This can be done by:
- Certain congenital heart disease s
- Enlarged or thick heart muscle that makes it more difficult to pump blood from your ventricles. Read more in the topic Cardiomyopathy Health.
- Heart attack
- Heart failure
Before you get a pacemaker- Pacemakers
Before deciding to get a pacemaker, discuss your options with your doctor. You can bring these and other questions you have with you:
- What are the benefits and risks of a pacemaker?
- What other treatment options do I have?
- How does a pacemaker affect my life?
- What Kind Of Pacemaker Is Best For Me?
- What happens during the procedure?
- How long will the pacemaker last?
Children can outgrow their pacemakers. If your child needs a pacemaker, ask what will happen when he grows up.
Preparing for the procedure
Unless it's an emergency, you and your doctor will schedule the procedure. Tell your doctor if you are allergic to any medications or latex, and if you are taking blood thinners or other medications. Before starting your procedure, make sure you and your doctor discuss the following questions.
- When should I stop eating or drinking before the procedure?
- Do I have to keep taking my regular medications?
- When should I arrive at the hospital and where should I go?
- How long should I expect to stay in the hospital?
- How long will my recovery take? Will I be sore or not able to move?
- What medications should I take after the procedure?
If you are given medication to relax or sleep during the procedure, contact someone who will drive you home. Depending on the procedure and your health, you can go home the same day or after a few days.
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