Pacemakers: What You Need to Know

Introduction

A pacemaker is a small device that helps regulate the heart's rhythm by sending electrical impulses to stimulate the heartbeat. It is used to treat arrhythmias, conditions where the heart beats too slowly (bradycardia), too fast (tachycardia), or irregularly.

How Does a Pacemaker Work?

A pacemaker consists of:

• A pulse generator – a small device containing the battery and electronic circuit.
• Leads (electrodes) – thin wires that connect the pacemaker to the heart.
• Sensors – detect the heart's natural electrical signals and respond if the rhythm is abnormal.

The pacemaker continuously monitors the heart's electrical activity and sends electrical impulses when necessary to ensure the heart beats at a normal rate.

Who Needs a Pacemaker?

Doctors recommend pacemakers for various heart conditions, including:

• Bradycardia – slow heart rate that causes dizziness, fatigue, or fainting.
• Heart block – a condition where electrical signals in the heart are delayed or blocked.
• Atrial fibrillation with slow heart rate – an irregular rhythm that sometimes leads to dangerously slow heartbeats.
• Heart failure – specific types of pacemakers, like biventricular pacemakers, help people with heart failure by improving the heart’s ability to pump blood.

Types of Pacemakers

There are different types of pacemakers depending on the patient’s needs:

• Single-chamber pacemaker – stimulates only one chamber of the heart (usually the right ventricle).
• Dual-chamber pacemaker – stimulates both an atrium and a ventricle, coordinating the heart’s rhythm more naturally.
• Biventricular pacemaker (cardiac resynchronization therapy, CRT) – helps people with heart failure by synchronizing the beating of both ventricles.
• Leadless pacemaker – a newer type of device implanted directly inside the heart without traditional lead wires.

Risks and Precautions

Pacemakers are generally safe, but there are some risks:

• Infection at the surgical site.
• Bleeding or swelling after the procedure.
• Lead displacement (wires moving from their original position).
• Device malfunction requiring adjustment or replacement.

Patients with pacemakers should avoid strong magnetic fields and check with their doctor before undergoing MRI scans or certain electronic device exposures.

Living with a Pacemaker

• Routine check-ups are necessary to monitor pacemaker function.
• Keep an ID card indicating pacemaker details.
• Avoid strong electromagnetic fields, such as security scanners and welding equipment.
• Stay physically active; most people can resume daily activities after recovery.

Conclusion

A pacemaker is a life-changing device that helps maintain a normal heartbeat and improves the quality of life. If you or a loved one have symptoms of arrhythmia, consult a cardiologist to discuss whether a pacemaker is the right choice.

Source recommendations

1. American Heart Association Guidelines on Pacemaker Therapy

1. https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/pacemaker
2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000627
3. https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/devices-that-may-interfere-with-icds-and-pacemakers
4. https://www.ahajournals.org/doi/10.1161/01.cir.97.13.1325
5. https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/living-with-your-pacemaker

2. European Society of Cardiology Guidelines on Cardiac Pacing and Resynchronization Therapy

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiac-Pacing-and-Cardiac-Resynchronization-Therapy
2. https://academic.oup.com/eurheartj/article/42/35/3427/6358547
3. https://pubmed.ncbi.nlm.nih.gov/34455430/
4. https://academic.oup.com/eurheartj/article/34/29/2281/401445
5. https://pubmed.ncbi.nlm.nih.gov/23801827/