Pacemakers
Introduction
The heart has the remarkable ability to beat rhythmically approximately
100,000 times a day and pumps about five quarts of blood each minute or 75 gallons of
blood every hour. Its steady pumping rhythm sends oxygen-rich blood and nutrients to all
of your body’s cells with each heartbeat.
You may need a pacemaker to keep the heart contracting regularly and
pumping blood. Your body gets the blood, oxygen and nutrients that it needs each time your
heart contracts. A pacemaker is a small battery operated unit that helps your heart beat
more regularly. It does this by generating a small electrical current which controls your
heartbeat.
You May Need A
Pacemaker If:
Your heart beats too slowly.
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Your heart doesn’t beat regularly.
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There is a block in your heart’s electrical pathways.
The heart has it’s own electrical conduction system. Special heart
tissues generate electrical signals that travel along pathways through the heart every
time it beats.
THE SINOATRIAL (SA) NODE
The heart’s natural pacemaker is called the Sinoatrial
or SA node and is located in the upper right chamber of the heart. The SA node
produces very small electrical impulses which vary in rate depending upon your body’s
demands for oxygen. Typically the SA node initiates a heartbeat at the rate of 60 to 100
beats per minute in the average person. If you are exercising or excited, the healthy SA
node responds to these changes in the body and increases your heart rate accordingly. When
the SA node is not working properly, it may send out slow or irregular impulses, causing
the heart to beat too slow or beat irregularly.
THE ATRIOVENTRICULAR (AV) NODE
After the electrical impulse leaves the SA node, it travels through the
upper half of the heart causing the top half of the heart to contract. From there it
travels to a junction called the Atrioventricular or AV node. The impulse
continues down the conduction pathways causing the bottom half of the heart to contract.
This regular contraction of the heart forces the blood out of the heart and into all parts
of the body. If the AV node and/or its electrical pathways do not function correctly, the
impulse may be blocked before it can reach the lower half of the heart.
THE PACEMAKER
The Pulse Generator contains a battery that supplies the
electrical energy and the circuitry that transforms the energy into small electrical
impulses which stimulate the heart to pump correctly.
The Pacing Lead is an insulated wire that carries the electrical
impulse to the heart and carries information about the heart’s natural pumping
ability back to the pulse generator. One end of the lead is connected to the pulse
generator. The other end of the lead is usually inserted through a vein and placed into
the chamber or chambers of the heart. One lead or two may be used, depending upon the type
of pacemaker prescribed by the physician.
The pacemaker Programmer has the ability to send and receive
information from the pacemaker. The programmer wand is held over the pacemaker and it
sends and receives signals to the pacemaker. A great deal of information, about your
pacemaker, can be gathered by using the pacemaker programmer. The programmer can also be
used to make adjustments to your pacemaker.
Many pacemakers work only when needed. They’re called
"demand" pacemakers. They shut off if your heart is pumping adequately. They go
on (or pace) only if your heart beat is too slow.
How The Pacemaker Is
Implanted:
You will be admitted to the hospital and your pacemaker surgery will be
done in the cardiac catheterization laboratory.
You will be given something to help you relax.
The incision is usually made in your left shoulder. The lead and
pacemaker will be tested and the pacemaker will implanted into the selected site.
The incision will be closed.
A dressing will be applied.
You may or may not spend the night in the hospital.
Click here for Pacemaker Chest X-Ray
Your Pacemaker
Follow-up
The next day the dressing will be removed, an ECG will be done
to check the heart and your pacemaker will be interrogated with a pacemaker programmer.
One week after your pacemaker implant, your staples will be removed
from your pacemaker incision. While you are in the office, you will be instructed on how
to check your pacemaker by telephone or (transtelephonic). You will be loaned a
transmitter at this time.
You will be phoned, to check your pacemaker on a regular basis,
according to insurance guidelines.
You will come into the office to have your pacemaker checked, at four
months, then yearly thereafter.
Biventricular Pacemakers
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