Pacemaker

What is a pacemaker?

A pacemaker is a small, battery-powered device that is implanted into your chest to help regulate your heart rate.


Why do I need a pacemaker?

You need a pacemaker if your heart beat is too slow or is irregular. Your heart may not be able to pump blood well throughout your body. This can happen because of heart failure, aging, or heart medications. You may have the following signs and symptoms:

  • You feel tired all the time or cannot do vigorous activities.

  • You are often dizzy.

  • You have a history of fainting.

  • You feel like you cannot catch your breath.

  • You are confused at times.

What kinds of pacemakers are there?

  • Temporary pacemaker: This may be used in an emergency if you have a heart attack or if medicine caused your heart to slow down too much. A temporary pacemaker may be used after heart surgery to help your heart. All temporary pacemakers have wires that attach to a device outside of your body. A temporary pacemaker is sometimes used until a permanent pacemaker can be put in.

  • Permanent pacemaker: This is used to help your heart on a long-term basis. A permanent pacemaker is about the size of a large wristwatch. It is made up of thin, flexible wires, called leads, and the pacemaker unit. The pacemaker unit contains a battery, a pulse generator, and a small computer that senses your heart rate. The battery powers the pulse generator, which sends electrical impulses to your heart so it will beat as it should. The pacemaker unit and leads are placed under the skin on your chest. Once inserted, you will probably be able to see the outline of the pacemaker unit under your skin.

How does a permanent pacemaker work?

Your heart rate can change with activity. For example, your heart rate is lower when you are resting than when you are exercising. Most permanent pacemakers will sense your heart rate. This type of pacemaker is called an on-demand pacemaker. When your heart rate is below a preset value, the pacemaker starts to work to help your heart beat faster. Once your heart is pumping at the right rate, it will turn off. It will turn on again when it is needed. It can be programmed to meet your individual needs after it is inserted in your chest. For example, it can be programmed to help your heart during exercise or stress. If you have had a pacemaker in the past, you may have had a fixed-rate pacemaker. This type of pacemaker keeps a set rate that does not change.

How is a permanent pacemaker implanted?

You will need a surgical procedure that lasts about 1 to 2 hours. Your caregiver will give you IV medicine to help you relax. In most cases, you will be awake, but very drowsy. Local anesthesia medicine will be injected to numb your skin. An incision will be made in the skin on your neck or chest. The leads of the pacemaker will be guided into your heart through a blood vessel. A second incision will be made to implant the pacemaker unit, usually just below your collarbone. The leads will be connected to the pacemaker unit. Both incisions will be closed with stitches. You will spend the night at the hospital after your procedure. This is done so caregivers can be sure your pacemaker is working as it should.

What are the risks of a permanent pacemaker?

  • You may have temporary bruising, pain, and swelling after the procedure. You could have problems breathing during the placement procedure. An infection could occur where your pacemaker is implanted. You could bleed more than usual or get blood clots. The pacemaker unit could move out of place and cause pain and bleeding.

  • You may have problems years after your pacemaker is implanted. The leads could move out of place or poke a hole in your lung, heart, or blood vessel. The pacemaker itself may cause your heart to beat irregularly. This can increase your risk of a stroke. Your pacemaker could stop working.

What do I need to know about a permanent pacemaker?

  • A pacemaker will likely help you feel better and have more energy. Most people can get back to their regular activities within several days of pacemaker surgery. You will need to limit the amount you lift and move your arm for a few weeks after surgery.

  • Your cardiologist will check your pacemaker and the battery at regular intervals. He may check it in his office or use a computer to check it over the telephone.

  • You will need to avoid welding equipment, MRI machines, and other equipment with large magnets or electric fields. These things could interfere with how your pacemaker works.

  • A pacemaker battery usually lasts 5 to 8 years. Eventually you will need to have the pacemaker unit replaced. Sometimes the leads need to be replaced as well.

Where can I find support or more information?

  • American Heart Association
    7272 Greenville Avenue
    Dallas , TX 75231-4596
    Phone: 1- 800 - 242-8721
    Web Address: http://www.heart.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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