In a heartbeat – implanting a pacemaker is not as dramatic as it sounds

Posted on 7 May 2013

Some 600 000 people a year globally get a pacemaker implanted to help regulate their heartbeat. Commonly used to treat bradycardia (a slow heartbeat), installing a pacemaker is generally minor surgery explains Dr Leonard Steingo, cardiologist at Mediclinic Morningside in Sandton.

I need to have a pacemaker implanted. How does it work and what does it do?
In most cases a pacemaker is implanted to correct a slow heartbeat, which might be causing you dizziness, feelings of faintness or fainting and shortness of breath. Whereas the heart usually beats at 60 to 90 times a minute, doubling or trebling under stress, your heartbeat has slowed down.

The heart is essentially a fist-sized pump, which uses electrical signals to initiate a contraction and send blood to the brain and body. The natural pacemaker in our heart is known as the sinoatrial or sinus node, which generates an electrical signal which can slow down with age, heart disease or medication such as beta blockers.

That’s where the pacemaker comes in. A neat sophisticated little device, it is placed under your skin near your heart to provide electrical signals and to rectify your heartbeat either temporarily or long term.

A pacemaker will monitor your heartbeat, and speed it up if it’s too slow.

What can I expect of my pacemaker procedure?
A pacemaker implant sounds dramatic, but in fact it is fairly quick and safe.
•    Performed under local anaesthetic in an hour or two, you will be given a sedative to relax and local anaesthetic to numb the area.
•    Generally your cardiologist will make an incision under your collarbone of between five and seven centimetres, and place the pacemaker with its computer circuitry and battery neatly under the skin under your collarbone.
•    One or more flexible leads or electrodes (you may either need a single-chamber or dual-chamber pacemaker) will be threaded to your heart via a large vein with the help of x-ray images. The electrode tip will rest against your inner heart so that electrical impulse can stimulate your heart to beat.

What happens after the procedure?
You may have to spend a night in hospital to make sure that your pacemaker is programmed to fit your heartbeat needs. Complications are rare, only occurring in one to two percent of cases, and these are generally readily treated.

You may find that you feel energised now that your slower heartbeat has been corrected and you will return to normal within a few days, bar being cautious about lifting heavy items or using your arm dramatically on the side of the incision and perhaps a feeling of bruising in the area. You may also notice a slight bump under your skin.

You will need to have a check-up after the implantation to check that your heartbeat is what it should be and at least annual check-ups thereafter. Some people need their pacemakers checking more often, and this is done externally in the doctor’s office using wireless technology.

Your pacemaker should last five to 10 years, depending on its battery life, at which point, you will need another implant to replace your pacemaker, although the wires can often remain in place.

Look out for my next post: myths and truths around life with a pacemaker…

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The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.

Published in Cardiology

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