There are few life-saving medical devices as well known as the pacemaker. More than a million of them are implanted each year, providing peace of mind for people whose hearts don’t beat as they should.
They’re designed to mimic a healthy heart’s natural rhythm. When a pacemaker senses disturbances or pauses in your heartbeat, it uses electrical impulses to nudge your heart back onto the right track.
Why You Might Need a Pacemaker
The most common condition that prompts people to get a pacemaker is bradycardia, where the heart beats too slow. Symptoms include weakness, dizziness, shortness of breath, fainting and confusion. Pacemakers also are used to help hearts that pause, or that beat too quickly (tachycardia) or irregularly.
Your cardiologist will first attempt to correct any abnormality through non-invasive treatments. But a pacemaker may be required to monitor and adjust your heartbeat as needed.
Common conditions that could lead to a pacemaker include:
Aging or heart disease: Regular wear-and-tear and stress from heart issues such as hypertension can damage your heart’s ability to set the correct rate. This can cause lower than normal heart rhythm, long pauses between beats or a vacillation between slow and fast rhythms (called sick sinus syndrome).
Heart block: This is the result of electrical signals traveling too slowly or not making it through your entire heart. Often the result of damage from a heart attack or aging, this condition disrupts the heart’s normal electrical activity.
Atrial fibrillation: Also known as AFib, this is defined by a racing or fluttering of the heartbeat as the heart’s top chambers (atria) and bottom chambers (ventricles) strain to control the pace. Affecting over three million Americans, AFib can be genetic or even brought on by certain medications.
Pacemakers have come a long way over the years. Once bulky mechanisms worn externally, today’s pacemakers are miniscule, internally-inserted devices driven by batteries that last more than a decade.
The three current types:
Wired transvenous pacemakers. Wires and electrodes are threaded through veins in your neck, chest or thigh to your heart’s chambers. The device is inserted through a small incision into your chest or stomach, where it is connected to the wires. This is the most traditional style in use and is commonly utilized when a patient requires only a temporary device.
Epicardial pacemakers. Electrodes attach to the surface of the heart rather than inside its chambers. The pacemaker is inserted through an incision below your ribs or armpit. The epicardial pacemaker is used as a precaution during heart surgery or when veins are blocked by a clot or plaque.
Wireless (or lead-free) pacemakers. The newest form of pacemaker is a small capsule-sized device placed in your heart using a catheter inserted through a vein in your thigh. Using X-rays as a guide, this simple procedure requires no incisions and is completed in under an hour, reducing risk of infection and healing time considerably.
With all three options, monitoring is wireless, so tracking your heart’s condition is as simple as being sure your remote is turned on.
How Will My Life Change?
Pacemakers allow patients to live longer with minimal inconvenience. But as with any medical procedure, receiving a pacemaker requires lifestyle adjustments and routine follow-up care.
Visit your doctor during the year to assure the pacemaker and battery are still working and to update any software changes. Batteries generally last more than ten years. Replacements are a simple procedure, since the electrodes are already in place.
Due to a pacemaker’s electromagnetic operation, there are some precautions you’ll need to take to avoid accidental signaling. Avoid close or prolonged contact with electronics or devices with strong magnetic fields. While most are safe for normal use, it’s recommended to keep the pacemaker at least six inches away from them.
Cell phones. Use the speaker or hold the phone to the ear on the side opposite to your pacemaker's location. Don’t keep your cell phone in a shirt pocket.
Headphones. Most have magnets, so don’t carry them in a chest pocket or around your neck.
Magnets. This includes those found in jewelry clasps, bracelets, mattress pads or pillows
Electric fences or pet containment systems.
Metal detectors. Some systems like those used for security at airports will cause the alarm to go off. Carry a card letting them know you're a pacemaker recipient to ask for a separate screening.
Additionally, there are medical and dental treatments that might interfere with your pacemaker. These include:
Magnetic resonance imaging (MRI)
Electrocautery — used during surgery to stop blood vessels from bleeding
Radiation therapy — used to treat cancer
Shock-wave lithotripsy — used to treat kidney stones
Transcutaneous electrical nerve stimulation (TENS) — used to treat pain
Talk to your doctors if you notice any changes or if additional health concerns require care that might interfere with your pacemaker's normal operation.
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