A pacemaker is a device that sends electrical impulses to the heart muscle to maintain a suitable heart rate or to stimulate the lower chambers of the heart (ventricles).
Our heart has its own internal electrical system that controls the rate and rhythm of our own heartbeat. With each heartbeat, an electrical signal spreads from the top of your heart to the bottom. As the signal travels, it causes the heart to contract and pump blood. Each electrical signal normally begins in a group of cells called the sinus node or sinoatrial (SA) node. As the signal spreads from the top of the heart to the bottom, it coordinates the timing of heart cell activity. First, the heart’s two upper chambers, the atria, contract. This contraction pumps blood into the heart’s two lower chambers, the ventricles.
As we get older, this electrical system may get worn out. It leads to a condition called a complete heart block which is diagnosed by a cardiologist looking at the ECG. The pacemaker would need to be implanted for such patients to keep them going.
Pacemaker insertion is done under local anesthesia. The patient will lie down on the table under the X-ray camera [ Cath lab]. A small cut is taken under the collar bone usually on the left side in right-handed people. Wires are passed into the heart chambers and fixed in the optimal position. An optimal position is judged based on electrical signals coming from the heart. Then these wires are connected to the pacemaker box which is implanted in a small pocket under the skin. The wound is closed and dressed. After a pacemaker insertion, the patient is kept in bed for 12 hours. The patient will have a chest x-ray on the next day and will be discharged home if stable. The patient is asked to refrain from lifting the left arm above the head for 6 weeks. This helps to prevent the movement of the leads placed in the heart chambers. The patient can live a normal life. The battery of the pacemaker will last about 10 years. This can be changed every 10 years on many occasions. Battery life will be monitored by the yearly checks by the technical team.