Pacemaker Implant

A pacemaker is a small implanted device that treats abnormal rhythms called arrhythmias. Specifically, a pacemaker treats slow arrhythmias called bradycardia. A pacemaker can usually eliminate symptoms like shortness of breath, fatigue and dizziness caused by bradycardia.

Arrhythmias result from a problem in your heart's electrical system. Electrical signals follow a certain path throughout the heart. It is the movement of these signals that causes your heart to contract. During bradycardia, however, too few signals flow through the heart. To learn more about your heart's electrical system, go to the Heart & Blood Vessel basics section.

A pacemaker restores your heart to a normal rhythm. The pacemaker can also adjust to your body's needs. This is because the device has sensors that can detect:

  • When you rest and need a slower heart rate
  • When you exercise and need a faster heart rate

Perhaps your heart does a good job of regulating your heart rhythm most of the time. A pacemaker is used as a backup treatment only when your heart needs it.

In other cases, a person's heart can no longer create it's own electrical signals, or send them down the proper pathways. For example, sometimes again, or an ablation procedure in certain parts of the heart can deliver continual treatment, in order to cause each heartbeat.

The pacemaker delivers electrical signals to the heart. The device does this by sending tiny amounts of electrical energy (too small to feel) to either the top or bottom chambers of the heart or both.

A device implant is a procedure that uses local numbing. General anesthesia usually is not needed.

How is the procedure done?

A pacemaker system has two parts.

DEVICE-the device is quite small and easily fits in the palm of your hand. It contains small-computerized parts that run on a battery.

LEAD- the leads are thin, insulated wires that connect the device to your heart. The leads carry electrical signals back and forth between your heart and your device.

Your doctor inserts the leads through a small incision, usually near the collarbone. Your doctor gently steers the lead through your blood vessels and into your heart. Your doctor can see where the leads are going by watching a video screen with real-time, moving x-rays called fluoroscopy.

The doctor connects the leads to the device and than tests to make sure both work together deliver treatment. Your doctor then places the device just underneath your skin and stitches the incision closed.

What can I expect?

Usually you are told not to eat or drink anything for a number of hours before the procedure. You undress and put on a hospital gown or sheet. Your procedure will be performed in a "cath lab". You lie on an exam table and an intravenous (IV) line is put into your arm. The IV delivers fluids and medications during the procedure. The medications makes you groggy, but not unconscious.

The doctor makes a small incision near your collarbone to insert the leads. The area will be numbed so you shouldn't feel bad, but you may feel pressure as the leads are inserted. You may be in the hospital overnight, and there may be tenderness at the incision site. Most people have a fairly quick recovery.