Pacemakers

What is a Pacemaker?
The human body has its own natural pacemaker within the heart which keeps it beating in a regular pattern by electrical impulses. If this is not working correctly you may need to have an artificial pacemaker fitted to stimulate the heart to beat regularly.

An artificial pacemaker is a small device, less than the size of a matchbox, which weighs just 20-50g (1-2 oz). It is battery operated and usually lasts six to ten years before it will need replacing. A wire (electrode or lead) runs from the pacemaker, through a vein, into the heart.

There are three types of pacemaker; a single-chamber pacemaker with one lead, a dual-chamber which has two leads, and a bi-ventricular pacemaker which has three leads. The type of pacemaker you require will depend upon your medical condition.

Why do I need one?

There are several reasons why a pacemaker may be required, one of the most common is to correct the rate at which your heart beats (how often it beats) or the regularity with which it beats. A pacemaker may also be fitted if you have certain types of heart block or suffer from heart failure. Some people who have certain types of ablation therapy may also need a pacemaker. Dr Ramrakha will explain the reason why it is required in your particular case.

How does it work?

The pacemaker contains an electronic circuit which generates electrical impulses which are passed down the lead into the heart. This stimulates the heart muscle to contract, producing a heartbeat. The rate at which this happens can be programmed into the pacemaker. Most pacemakers work by sensing a missed beat or slow heart rate and react accordingly.

How is the pacemaker fitted?

The procedure can often be done as a day-case but in some cases you may need to stay in hospital overnight. It is usually done under local anaesthetic and takes 30-60 minutes. The wires (leads) are inserted into the veins and passed through into the heart using an x-ray machine. The pacemaker is then implanted under the skin at the top of the chest, just below the collar bone.

What can I expect after the procedure?

  • Before you leave hospital, your pacemaker will be checked and you will have a chest x-ray.
  • You may be aware of the pacemaker but will quickly get used to it.
  • You may have some bruising and discomfort at the site for a few days for which you may take painkillers such as paracetamol.
  • You may be given antibiotics to reduce the risk of infection. If you develop any redness, swelling or discharge at the site or develop a fever, contact your GP immediately. The risk is small but it is important an infection is treated. If it is allowed to spread, it may mean the pacemaker will need to be replaced.
  • You should avoid strenuous activity for at least a week and vigorous arm movements for about three weeks to reduce the risk of displacing the pacing wires.

What other advice must I follow?

  • You must attend regular pacemaker check ups usually once a year, depending on the type of pacemaker.
  • You will be given a Pacemaker Registration Card showing information about your type of pacemaker. Carry this with you at all times.
  • Show your Pacemaker Registration Card to the technician, doctor or dentist when you have future medical tests or treatment.
  • You must inform the DVLA of your pacemaker insertion and must not drive for a week. If you have an HGV or PCV licence, please follow DVLA guidelines.
  • You can continue to use a cordless or mobile phone but keep it as far as possible from your pacemaker.
  • Electronic security devices in shops and airports are safe provided you pass through quickly. They can cause interference with your pacemaker.
  • You must not have an MRI scan which uses strong magnets. Other types of scan are safe.

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