Medical News Today: What to know about heart pacemakers

By | March 11, 2019
A pacemaker is a device that helps keep the heart beating regularly. It can represent a life-changing treatment for heart conditions such as arrhythmias, which involve the heart beating irregularly.

Inserting a pacemaker into the chest requires minor surgery. The procedure is generally safe, but there are some risks, such as injury around the site of insertion.

This article will discuss the purpose of a heart pacemaker, the insertion surgery, and the risks.

Purpose

Close up image of a heart pacemaker
Doctors use pacemakers to treat heart conditions.

A pacemaker is a small electronic device for treating heart conditions, such as arrhythmias. This refers to a group of conditions that disrupt the rhythm of the heart.

The heart has two upper and two lower chambers. The upper chambers contract, pulling blood into the heart’s lower chambers.

When the ventricles contract, they push this blood out of the heart so it can circulate throughout the body. This contraction is a heartbeat, and electrical signals are responsible for controlling the rhythm.

Cells in the upper chambers generate these electrical signals, which travel down the heart and coordinate its activity. An arrhythmia disrupts this electrical signaling, causing the heart to beat irregularly.

Tachycardia involves the heart beating too quickly, and bradycardia involves the heart beating too slowly. The heart can also beat irregularly in other ways.

Arrhythmias can prevent the heart from supplying blood properly. This can cause symptoms such as:

  • fatigue
  • weakness
  • fainting
  • a rapid heartbeat
  • shortness of breath
  • chest pain

Severe cases can cause lasting damage to internal organs or cardiac arrest. A pacemaker can help reduce these symptoms by using electrical pulses to influence the rhythm of the heart. Depending on the problem, a pacemaker can speed up, slow down, or stabilize the heartbeat.

Pacemakers can address specific problems, such as atrial fibrillation. In this form of arrhythmia, the heart’s upper chambers do not contract properly, and the ventricles are unable to pump enough blood out of the heart.

A pacemaker can ensure that the upper chambers contract properly. If a pacemaker is treating an arrhythmia, it is usually permanent.

Doctors can use pacemakers to monitor these types of conditions, and the devices can record a range of important health indicators, including heart activity. A pacemaker can automatically adjust the heart’s electrical pulses, according to the information it records.

Otherwise, a person may need a temporary pacemaker, typically in response to acute heart trauma, such as a heart attack or drug overdose.

Procedure

X-ray showing a heart pacemaker
The surgery to insert a heart pacemaker is a straightforward procedure.

Surgery is necessary to insert a pacemaker into the chest.

When preparing for the procedure, the doctor will assess the person’s medical history and take blood tests. There will be forms to fill out, and the person will also need to fast.

Before the surgery, a healthcare provider will insert an intravenous drip into a vein in the arm or hand. This will deliver a sedative and any other necessary medications.

The doctor will then clean the injection site, which is near the shoulder. Next, they will insert a needle into a vein just below the collarbone.

The doctor will use this needle to thread the wires that control the pacemaker through the veins, toward the heart. There are between one and three wires, depending on the type of pacemaker.

The doctor will use fluoroscopy to guide the needles correctly. This involves continuous X-ray imaging that feeds live pictures to a monitor. They will test the wires to ensure that they are working properly before proceeding.

The doctor then makes a small cut in the chest and inserts the pacemaker’s generator and battery, which may resemble a small box. Finally, they will seal the incision and use an electrocardiogram to test the device.

After surgery, it is often necessary to stay overnight in the hospital. This allows doctors and nurses to ensure that the device is working properly.

Risks

Inserting a pacemaker is a relatively safe procedure.

A person is likely to feel some pain or tenderness around the area of insertion, but this should be temporary. Other risks involve:

  • swelling or bleeding at the site of insertion
  • infection
  • blood vessel or nerve damage
  • a collapsed lung
  • a reaction to medications

Outlook

Inserting a heart pacemaker is a fairly straightforward and safe surgical procedure.

A period of rest will be necessary, but a person can usually return to their regular routine within a few days.

For the first 8 weeks, it is important to avoid sudden movements that involve moving the arms away from the body.

Living with a pacemaker will require some adjustments. These include:

  • avoiding putting pressure on the pacemaker
  • knowing the pacemaker’s upper and lower heart rate limits and ensuring that the heart rate stays within these limits
  • remaining physically active, but stopping before getting too tired
  • restricting contact with devices that can interfere with the pacemaker, such as mobile phones and microwave ovens
  • visiting a doctor for checkups and if any problems occur

An arrhythmia is a lifelong condition that can become severe. Pacemakers are a highly effective form of treatment, and they can help people with the condition lead relatively regular lives.

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