Regulating your heart beat

Posted on 30 July 2012

Our expert is Dr Melt van der Spuy, a specialist cardiologist with a practice at the Mediclinic Heart Hospital in Pretoria. During his career of almost 22 years, he has inserted close to 18 000 pacemakers. 

I often feel dizzy, out of breath and very tired. What could be the problem?
Dizziness, shortness of breath and fatigue are often tell-tale signs that your body is not getting enough blood and oxygen. This can result from your heart beating irregularly or too slow because of the electrical pulses signalling contraction not being conducted properly across the heart muscle. Your doctor will be able to confirm faulty electrical conduction across your heart with an ECG, an echocardiogram or a stress test.

How can a pacemaker help to correct my heartbeat?
A pacemaker is a small electronic device that sends an electrical current to your heart muscle at regular intervals or if it detects that your heart has missed a beat. It consists of a small electric circuit and a battery, encased in a metal casing, and one or more conducting wires called leads. The type of pacemaker that is needed depends on where in the pathway the conduction disruption occurs.

How is the pacemaker inserted?
The doctor will make a small incision below your collar bone and then create a pocket under the skin in which to insert the metal box. With the help of an image projected on a screen, the leads are then threaded through the subclavian vein towards the heart chambers. Once in place the system is tested to ensure that everything works correctly and to determine the optimal settings for the device. The procedure can be done under either general or local anaesthesia. I prefer to use general anaesthesia as I find patients feel more comfortable and less anxious.

What is it like to live with a pacemaker?
The goal of pacemakers is to return patients to a normal, active lifestyle. Because the device is inserted under the skin, it won’t be visible from outside and you will hardly know it is there. You can still exercise and participate in sport. In fact, one of my patients has completed the Comrades! Contact sports like rugby and boxing, however, are not recommended.

You may set off metal detectors at airports, banks and shops, but this will not interfere with your pacemaker’s functioning. It’s best to carry some identification on you to show that you have a pacemaker. You will have to visit your doctor for regular follow-ups – usually every six months – to check device functioning. The battery usually needs to be replaced after eight to 10 years.

If you have any questions on these or any other pacemaker-related issues, add them as a comment below or click on the Facebook link to post them there.
For questions specific to your condition, talk to your doctor. 
To find a Mediclinic doctor near you, click on the FIND A DOCTOR/HOSPITAL link on the right.


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

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

Post a comment

Leave a reply