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Pacemakers are treatment for dangerously low heart beats. A slow heartbeat can lead to weakness, confusion, dizziness, fainting, shortness of breath and death. A slow heartbeat can be a side effect of certain medications in which case discontinuation of the medicine or a reduction in dosage may correct the problem.
The conduction system of the heart becomes irreversibly damaged for any one of a number of reasons. Some people take medications that cause slow heartbeats as a side effect in order to prevent other serious problems. Since there is no medication you can take to speed up your heartbeat, the pacemaker is our only solution at this time.
Having a pacemaker implanted is only a minor surgical procedure. The procedure takes around one hour. It is not open-heart surgery and most people resume their previous lifestyle with little or no limitations. This procedure is done while the patient is under mild sedation and a local anaesthetic; patients are not usually put to sleep. There are two places where the pacemaker can be inserted. The first one is in the collarbone and the second one, which is much more rare, is in the abdomen. I will be discussing the collarbone implantation. A two-inch incision is made parallel to and just below the collarbone. Pacer wires are then inserted into a vein that lies just under the collarbone and advanced through the vein under fluoroscopic guidance into the heart. The other end of the pacer wires are connected to an inch deep and one and a half inches wide generator that is implanted under the skin beneath the collarbone. The skin is sutured closed and the patient usually leaves the hospital the same day or the following day. Incision pain is mild and transient and usually responds to Tylenol. It is possible to feel the generator under the skin and a slight deformity of the skin is visible.
Patients may not shower for a week after the procedure so that they keep the incision dry. They should also avoid excessively using the arm on the side of the pacer for that week. As well there are some precautions that need to be taken but that will be covered in the page labelled RISKS.
The batteries give off warning signals when they are running low on power many months before they actually fail. This can be detected by either a telephone check or by a formal appointment. Pacemakers are usually checked at least two times a year. Changing the generator is really simple. They remake the same incision, removing old generator and plugging the existing wires into the new generator. Again the patient goes home the same day.
Another use for pacemakers is for a disease called Hypertrophy Obstructive Cardiomyopathy. This disease is where the overgrown heart muscle blocks the access of blood out of the heart. By altering the electrical activation pattern of the hearts muscle, pacemakers can help alleviate this problem.
There are two investigational uses of pacemakers. They are researching about having the rhythms to the atria from two sites instead of just one. This is to improve pumping abilitiy of the lower chambers of the heart when they have been damaged from some disease.  |
