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Why is the doctor performing this procedure?
When the
sinoatrial (SA) node or sinus node (the body's natural pacemaker) becomes
defective, the heart may beat too fast, too slow, or irregularly--all of which
are referred to as arrhythmias. An artificial pacemaker is used to treat a
dangerously slow heart rate, to help it beat at a more healthy rate.
What is a pacemaker?
A pacemaker is a small, artificial
electrical device which assists, or in some cases, replaces the function of the
(SA) node. Frequently, pacemakers are necessary following a heart attack or
cardiac surgery. Without treatment, a slow or irregular heart rate can lead to
weakness, confusion, dizziness, fainting, shortness of breath and even death.
There are two types of pacemakers: permanent (implantable) and temporary
(external). Your doctor will advice you as to which device is most suitable
depending upon your condition.
Most pacemakers are demand pacemakers. Demand pacemakers have a sensing
device which paces the heart (turns the device off and on) as needed--off when
the heart beat is too fast and on when it is too slow. Patients are usually
completely unaware of when the device is pacing their heart.
What happens during a pacemaker procedure?
A pacemaker
implantation is a minor procedure requiring only mild sedation and a local
anesthetic (patients are generally not put to sleep). A small, approximately
2-inch incision is made parallel to and just below the collarbone. A thin
flexible wire (called the lead) is inserted into a vein that lies just under the
collarbone. The doctor advances the lead through that vein under fluoroscopic
(x-ray like) guidance into the heart. Once the lead enters the heart, the doctor
attaches it to the tissue inside the heart. At this point, the doctor will test
the lead to see if it is in a suitable place for pacing. The testing is not
painful. After the lead test, your doctor may decide to move the lead and
perform the test again. Repositioning and retesting a pacing lead several times
is not unusual during a pacemaker procedure.
The other end of the pacer wires are connected to a "generator" that is
implanted under the skin beneath the collarbone. This generator is about half an
inch deep and one and a half inches wide. The skin is then sutured closed and
the patient leaves the hospital later that same day or the following day.
Do pacemaker batteries wear out?
The pacemaker contains
batteries that will wear down over time, just like any electronic device. Most
batteries last at least 5 years. Using a special analyzer, the doctor can detect
the first warning that the batteries are running down. This can be done before
you detect any changes yourself. A sudden major slowing down of your heart rate,
which you may detect, indicates a more serious problem. If that occurs, call
your doctor.
If I have a pacemaker, are there electrical devices to
avoid?
Yes. Keep the following potential sources of strong
electrical or magnetic fields at lease 30 cm (12 inches) away from your
Pacemaker.
- Large stereo speakers
- Strong magnets
- Magnetic bingo wands
- Magnetic wands and detectors used in airport security
- Industrial equipment like power generators / arc
welders
- Avoid leaning over running engines
- Many amusement park rides have strong magnets and
should be avoided.
- Talk on your cell phone your ear opposite the pacemaker placement
Where is the test performed?
In the cardiac catherization
lab.
How long does this test take?
Typically the procedure
takes 1-2 hours to perform.
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