Sometimes a problem with the heart’s electrical system can cause an abnormal rhythm that prevents the heart from pumping blood effectively. The heart may beat too fast, too slow or with an irregular rhythm. This is called an dysrhythmia. Severe dysrhythmias can damage vital organs and may even lead to loss of consciousness or death. An implanted pacemaker can help overcome this faulty electrical signaling using low-energy electrical pulses.
Baptist Health is nationally recognized for excellence in treating abnormal heart rhythms with pacemaker implants. We offer a full spectrum of heart care and the latest approaches to treating abnormal heart rhythms with pacemaker implants. Best of all, you’ll appreciate convenient appointment times, locations near you and a personalized focus to meet your needs before, during and after your procedure.
What Is a Pacemaker Implant?
A traditional pacemaker is a small device with two parts — a pulse generator and wires (leads, or electrodes) — placed under the skin of the chest to help control the heartbeat. The leads detect the heart’s rhythm and transmit this information to the generator, which directs the battery to send electrical pulses to the heart.
Newer, leadless pacemakers are small, implantable devices that send electrical pulses to the heart whenever they sense an irregular rhythm. Leadless pacemakers are placed directly in the heart without the need for a surgical pocket and insulated wires (leads). Leadless pacemakers are made up of computer chips and a small battery in a sealed case. The device is implanted through a vein in the thigh and does not require surgery like a traditional procedure. Currently, these are only used in patients with certain medical conditions and a slow heart rate (bradycardia) who need single-chamber stimulation only.
What Can a Pacemaker Implant Accomplish?
Pacemakers can detect abnormal rhythms and regulate the rhythm of the heart. Different types of pacemakers accomplish different tasks, depending on a patient’s specific needs.
Single-chamber pacemakers carry electrical impulses from the pulse generator to the right ventricle of the heart. Dual-chamber pacemakers carry electrical impulses to the right ventricle and right atrium and control timing of contractions between the two chambers. And biventricular pacemakers stimulate both lower chambers of the heart to help the heart beat more efficiently.
- Help the heart pump blood more effectively, supporting vital organs and body systems
- Increase energy levels
- Reduce shortness of breath
- Help people return to normal, everyday activities
What Can I Expect During the Procedure?
If your physician determines you need a traditional pacemaker, you will be sedated and given local anesthesia. Your surgeon will make a small incision in your upper chest and guide the lead (wire) through a vein and into the heart. The surgeon will then connect the lead to the pacemaker (pulse generator), program the device and insert the pacemaker beneath your skin in the upper chest. After testing the device, your surgeon will close the incision. Surgery typically takes a few hours. You may have a small scar from the incision, and you’ll see a small lump where the device is inserted under the skin.
Placement of a leadless pacemaker doesn’t require a chest incision. Instead, while you’re sedated, your surgeon will insert a catheter into a vein in your upper thigh through a very small incision and use the catheter to move the tiny device into the right heart ventricle. After testing the device, your surgeon will close the tiny incision. This procedure takes less time than traditional pacemaker implantation. Scarring is typically minimal or nonexistent, and you will have no visible lump.
After a traditional pacemaker implantation, most people stay in the hospital for one day. You’ll schedule a follow-up with your surgeon or cardiologist to ensure your pacemaker’s settings are working correctly for you. After your surgery, your physician may recommend avoiding vigorous exercise or heavy lifting for about a month. You may have some pain near the area where your pacemaker was implanted. If you do, check with your physician to see if you can treat it with over-the-counter pain medications. And, if you experience redness or swelling at the incision site or fever, call your physician as this could indicate infection.
A one-day hospital stay is also common after leadless pacemaker implantation, but recovery is typically faster and restrictions on lifting and vigorous exercise is limited to one week.
Estimated Recovery Timeline
Recovery from traditional pacemaker implantation can take from a few days to a few weeks. Because of your mobility restrictions after surgery, you may need physical therapy or an exercise regimen to regain shoulder/upper body strength and range of motion. This is typically not the case after leadless pacemaker implantation, which often offers a shorter recovery time and fewer lifting and exercise restrictions.
Following both procedures – after you’ve healed and have confirmed your pacemaker settings are correct through follow-ups with your surgeon or cardiologist – you still have to take some precautions to ensure electrical interference doesn’t alter your pacemaker’s function. Typical recommendations include:
- Avoid placing your cellphone directly over your pacemaker implantation site when the phone is turned on.
- Avoid lingering near or leaning against a metal-detection system, and carry an ID card stating you have a pacemaker when going through airport security.
- Tell all medical personnel that you have a pacemaker, especially if they’re considering sending you for any medical procedure with intensive exposure to electromagnetic energy – like an MRI, radiation for cancer treatment, shock wave lithotripsy for gallstones or kidney stones, or surgery (during which a surgeon may use electrocautery to control bleeding).
- Try not to stand within two feet of welding equipment, high-voltage transformers or motor-generator systems.
Pacemaker Implant Possible Risks
Risks associated with traditional pacemaker implantation are rare but may include:
- Lead breakage
- Vein blockage or damage
Leadless pacemakers don’t have breakage, dislodgement or vein blockage risks, and infection is rare.
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