What is Heart Pacemaker Implantation?

The heart has a conduction system that transmits electrical impulses to keep the heart muscles in appropriate rhythm. These electrical impulses are generated in the right atrium by specific Sino Atrial tissues (S A nodes), and subsequently spread throughout the upper chambers. The Atrioventricular node, which connects the auricles and ventricles, distributes the impulses. Another group of tissues known as the Bundle of Hiss is in charge of electrical conduction, which causes the ventricles to contract and pump blood to the body and lungs. These three together make up the heart’s natural pacemakers.

Arrhythmia is a disease that occurs when electrical impulses in the heart are interrupted.

Brady arrhythmias occur when the heart beats too slowly. Heart block or sinus bradycardia can be the cause. Sinus bradycardia is caused by the natural pacemakers slowing down. A block or delay in the conduction of electrical impulses in the heart causes heart block. Heart blocks come in a variety of degrees and types, such as 1st-degree AV block and 2nd-degree AV block.

Tachyarrhythmias occur when the heart beats too quickly. Pacemakers are used to treat ventricular tachycardia and atrial fibrillation, two forms of tachycardia. Ventricular tachycardia is caused by fast contractions in the ventricles, which can result in cardiac collapse. Atrial fibrillation is a condition in which the atria fail to pump blood into the ventricles.

Arrhythmias can cause the following symptoms:

• Syncope and dizziness
• Shortness of breath and palpitations
• Confusion in the mind
• Fatigue

The following are the causes of cardiac arrhythmias:

• The natural aging of cardiac muscles
• Coronary artery disease (CAD)
• Angina pectoris (heart attack)
• Congenital heart defects
• Certain medications

A pacemaker is a surgically implanted device that sends tiny electrical impulses to the heart muscles to maintain or restore normal heart rate in cases of slow or unpredictable heartbeat. Brady-arrhythmia is the most common reason for pacemaker implantation; however, the decision is made based on the source of the arrhythmia, the severity and permanence of the condition, symptoms, and the patient’s risks.

The artificial pacemaker consists of the following components:

A pulse generator comprises a thin metal box that produces the electrical impulses and a computer processor to set the rate, pattern, output, and other parameters.

Leads to carrying electrical impulses to the heart muscles from the generator.

Electrodes at the ends of leads transmit electrical impulses to the heart muscles.

When is Pacemaker Required?

To help manage your heartbeat, a pacemaker is inserted. When you have a slow heartbeat (bradycardia) after a heart attack, surgery, or medication overdose but your heartbeat is predicted to recover, your doctor may consider a temporary pacemaker. A pacemaker can be permanently placed to treat heart failure or to rectify a chronic slow or irregular heartbeat.

Types of Pacemakers

Pacemakers are classified as:

Single-chamber pacemakers: These carry impulses of either the right atrium or right ventricle.

Dual-chamber pacemaker: This has two leads, to the right atrium and right ventricle so that a more natural approach of the heart activity is obtained.

Triple-chambered pacemaker: This leads to the right atrium, the right ventricle, and left ventricle. It is used in cases when the heart muscles are weak.

Biventricular Pacemaker: commonly known as cardiac resynchronization therapy, is a treatment for people with heart failure and irregular heartbeats. The right and left ventricles (lower heart chambers) are stimulated by this type of pacemaker, which causes the heart to beat more efficiently.

There are different types of pacemakers to restore or maintain a regular heartbeat:

• Demand pacemakers operate when the heart’s own pacemaker is slow.
• Rate-responsive pacemakers increase or decrease heart rate according to the body requirement like in rest or during activity.

How is the Pacemaker Implantation Procedure Done?

Pacemaker implantation procedure is done by specially trained cardiologists or electrophysiologists who are experienced to perform such procedures. It can be done under local or general anesthesia. Fluoroscopy is used for imaging of the procedure. The type of device decides the length of the surgery.

What is the Recovery After Pacemaker implantation Like?

Recovery after pacemaker implantation is rapid, but arm movement and activity restrictions are advised for the first few weeks. The hospital stay is short, a day or two after the surgery. Routine activities can be resumed in about two weeks.

What Results Can I Expect from Pacemaker Implantation?

Properly implanted pacemakers resolve arrhythmias and other symptoms of abnormal heart rate. Pacemaker usually lasts up to 10-15 years on average. It can be replaced after that time.