Heart rhythm problems (arrhythmia) occur when the electrical impulses
produced by your heart that coordinate heartbeat do not function properly,
causing your heart to beat too quickly, too slowly, or irregularly. Age
increases the probability of experiencing an arrhythmia. It can occur in people
who do not have heart disease. Some heart arrhythmias are harmless, though some
types, such as ventricular tachycardia (fast heart rates), are serious and even
life threatening.
Pacemakers represent one of the
earliest and most successful nonpharmacological therapy for arrhythmias.
Millions of pacemakers have been implanted since the very first pacemaker was
implanted. Drugs are no longer used except in the very acute setting before
implantation of a temporary or permanent pacemaker.
A
cardiac pacemaker is a device that is used to regulate the heart rate.
If you have been found to have a
heartbeat that is too slow, a pacemaker can be implanted in the body to take
over the function. This small electronic device automatically monitors and
regulates the heartbeat, by transmitting electrical impulses to stimulate the
heart when it is beating too slowly. A pacemaker consists of a pacing lead and
a pulse generator. Single chamber pacemakers have only a single lead while dual
chamber pacemakers have two leads with one lead in the atrium and the other in
the ventricle. Dual chamber pacemakers are more physiological but more
expensive.
Types of pacemakers
Single chamber pacemakers are pacing systems
that use one lead in either the right atrium or the right ventricle of your
heart.
A single lead in the right atrium is
commonly used in conditions where the normal pacemaker of the heart is not
working adequately, such as in the case of sick sinus syndrome. Atrial
pacing is used when the sinus node is sending out signals that are too slow or
irregular. However, to use this method of pacing, the rest of the heart's
normal conduction system must be functioning normally.
More commonly, the single lead is
placed in the right ventricle to help correct a slow or irregular heart beat.
This is most often the case when the electrical flow is slowed or blocked in
the region of the atrio-ventricular (A-V) node and the normal impulses from the
atria cannot reach the ventricle. This would result in too slow a heart beat.
The pacemaker system would keep the heart beating at a steady rate
Dual chamberpacemakers are
pacemaker systems that use a lead in the right atrium as well as the right
ventricle (figure 6). This type of pacing most closely mimics the heart's
normal conduction pattern by pacing sequentially from atria to ventricle thus
maximizing the heart's pumping ability. By having a lead in both the atria and
ventricle the pulse generator is able to continuously regulate the heart's
electrical activity in both chambers. These are the most commonly used
pacemakers at the present time.
Commonly asked questions about pacemakers
Will I need to make
any lifestyle changes after my pacemaker is implanted?
There
are no significant lifestyle changes that you will need to make as a result of
having a pacemaker implanted. Most patients resume their normal activities soon
after implantation. Specific issues or concerns should be addressed with your
pacemaker physician or nurse.
How often will I need
to have my pacemaker checked?
Your
pacemaker system will need to be evaluated by your pacemaker physician, nurse,
or your local cardiologist's office at least twice yearly. A special computer
called a programmer is used to perform a comprehensive evaluation
of your pacemaker system. The programmer has a wand (like a computer mouse) that is used to
communicate with the pacemaker. The wand is placed on your chest directly over
the pulse generator and a radio wave signal is used to send and receive information
from the pulse generator. Changes in the pacemaker settings can be done via
this method as well. A complete assessment of the pacemaker's sensing and
pacing functions, battery life, and diagnostic information is obtained, which
enables your pacemaker physician/nurse to fine tune your care.
How is the battery
changed?
The
battery that is used to power your pulse generator is tightly sealed within the
metal shell of the device. Therefore, when the battery's energy is depleted a
whole new pulse generator must be implanted. The skin over the pulse generator
site is numbed up with local anesthetic. You may also receive a light sedative
through a intravenous line to help you relax. A new incision is made in the
skin and the pacemaker pocket is opened. The pulse generator is removed and
lead(s) disconnected. At this time the lead(s) are hooked to a special analyzer
that evaluates the lead(s) for any evidence of potential malfunction. A new
pulse generator is then attached to the lead(s) and the system is reimplanted
in the same pocket. The incision is sutured (sewn) together and a small
dressing applied. Most patients can go home the same day as their procedure.
Can I use a
microwave?
Microwave
ovens will not interfere with the proper functioning of your pacemaker. You can
use a microwave oven without concern.
Can I use a cell
phone?
It is
possible that a cellular phone might interfere with the normal functioning of
your pacemaker. The interaction is temporary, however, and will only affect the
pacemaker during the time that your cellular phone is close to your pacemaker.
To avoid this potential interference, it is recommended that you hold the
cellular phone on the opposite side of your body away from the pacemaker. You
should also not store your cellular phone in your breast pocket.You should
always try to maintain a distance of at least 6 inches between your cellular
phone and your pacemaker system.
Do I have to take
any precautions at the airport?
If
you were to walk through the metal detector at the airport, it will not harm
you nor your pacemaker. However, because the pacemaker is encased in a metal
shell, it is possible that the pacemaker may set off the security alarm. To
avoid this problem, it is generally recommended that you show your pacemaker
identification card to the security agent and inform him/her that you have an
implanted pacemaker system. They should let you pass around the metal detector.
If the airport security wants to scan you with the "hand wand",
they can everywhere except over the device. This information also pertains
to any metal detector such as at a courthouse or federal building.
Thanks for sharing the wonderful information with us. This Pacemaker implantation is good process to cure the heart rhythm problems. This is done for my uncle at Hyderabad. Amaze that how science can work, technology is truly making wonders.
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ReplyDeleteWelcome to Novena Heart Centre, Know about HEART ATTACK - symptoms disease, treatment. Novena Heart is national heart center and available Cardiologist Singapore.