By ommantra A healthy heart beats in a steady rhythm, controlled by the electrical signals that coordinate the contraction of heart muscles. However, for individuals experiencing irregular heart rhythms (arrhythmias), a permanent pacemaker may be necessary to help maintain a regular heartbeat.
In this blog, we will explore what permanent pacemaker implantation is, the types of pacemakers, the procedure involved, and what you can expect after getting one.
What Is a Permanent Pacemaker?
A permanent pacemaker is a small medical device that is surgically implanted under the skin, usually near the chest, to help control abnormal heart rhythms. The pacemaker sends electrical impulses to stimulate the heart to beat at a normal pace when its natural rhythm is too slow (bradycardia) or irregular.
Pacemakers are designed to be a long-term solution, providing support for patients who experience chronic heart rhythm problems.
When Is a Permanent Pacemaker Necessary?
A pacemaker is recommended when the heart’s natural electrical system is unable to maintain a normal rhythm, leading to problems like:
- Bradycardia (slow heartbeat): The heart beats too slowly, reducing the amount of oxygen-rich blood flowing to the body.
- Heart block: Electrical signals between the upper and lower chambers of the heart are partially or completely blocked.
- Arrhythmias: Abnormal heartbeats that can cause fatigue, dizziness, fainting, or chest pain.
In such cases, a pacemaker can restore the heart’s ability to maintain a steady rhythm, improving the patient’s overall quality of life.
Types of Permanent Pacemakers
There are different types of pacemakers designed for various heart conditions. Your cardiologist will recommend the most appropriate type based on your specific heart rhythm problem.
- Single-Chamber Pacemaker: This pacemaker has one lead that connects to either the right atrium or the right ventricle of the heart. It is typically used for patients with bradycardia.
- Dual-Chamber Pacemaker: This pacemaker has two leads, one in the right atrium and one in the right ventricle. It helps coordinate the timing of the contractions between the upper and lower heart chambers.
- Biventricular Pacemaker (CRT Device): This device has three leads to stimulate the right atrium, right ventricle, and left ventricle, helping patients with heart failure by improving the heart’s pumping efficiency.
The Pacemaker Implantation Procedure
Pre-procedure
Before implantation, your cardiologist will evaluate your heart condition using tests like an ECG (Electrocardiogram), Holter monitoring, or Echocardiogram to determine the need for a pacemaker.
The Procedure
Pacemaker implantation is a minimally invasive procedure typically performed under local anesthesia with sedation. The steps include:
- Small Incision: A small incision is made under the collarbone.
- Lead Insertion: Thin, insulated wires (leads) are inserted through a vein and guided to the heart chambers using X-ray guidance.
- Pacemaker Placement: The pacemaker device, which is about the size of a matchbox, is placed under the skin near the collarbone. The leads are then connected to the pacemaker.
- Testing: Once the pacemaker is in place, your doctor will test it to ensure it is working correctly and set the proper rate and pacing intervals.
The procedure usually takes about 1-2 hours, and most patients can go home the same day or the next day.
Life After Pacemaker Implantation
Recovery
After pacemaker implantation, you may experience mild discomfort or swelling near the incision site. You will be advised to avoid strenuous activities or heavy lifting for a few weeks to allow the incision to heal properly.
Long-Term Care
- Regular Checkups: You will need regular follow-up visits with your cardiologist to ensure the pacemaker is functioning correctly and to monitor battery life.
- Avoiding Certain Devices: Some devices, such as strong magnets or certain medical equipment, can interfere with your pacemaker. Always inform healthcare providers that you have a pacemaker before undergoing medical procedures like MRI scans.
Lifestyle Changes
Most patients can return to their normal activities after recovery. You can engage in moderate exercises like walking or swimming but should consult your doctor before starting any vigorous physical activity.
How Long Does a Pacemaker Last?
Permanent pacemakers are designed to last for several years, typically between 5 and 15 years, depending on usage. The battery life is monitored during follow-up appointments, and when it runs low, a simple outpatient procedure will replace the pacemaker’s battery.
Risks and Complications
While pacemaker implantation is generally safe, there are potential risks associated with the procedure, such as:
- Infection: At the incision site.
- Bleeding or bruising: At the implant site.
- Lead displacement: Movement of the wires requiring repositioning.
- Device malfunction: Although rare, issues with the pacemaker itself.
Your cardiologist will carefully monitor you post-procedure to ensure a smooth recovery.
Conclusion
Permanent pacemaker implantation is a life-saving procedure for individuals with chronic heart rhythm disorders. It helps restore the heart’s normal rhythm, allowing patients to live healthier, more active lives. While the procedure may seem daunting, advancements in technology have made pacemaker implants safer, smaller, and more efficient.
If you or a loved one is experiencing symptoms of arrhythmia or other heart-related issues, consult with a cardiologist to explore the option of a permanent pacemaker.
