Permanent Pacemaker Implantation

What is a Pacemaker?

A pacemaker is a device that is implanted in a person's chest that delivers small electrical impulses to the heart muscle used to stimulate the ventricles of the heart and to maintain an appropriate heart rate.  It is also used to treat patients with syncope (fainting), CHF (congestive heart failure) and cardiomyopathy, which is a condition where the heart becomes inflamed and does not work as well as it should.

There are different types of pacemakers from which the physician will choose from and decide which is best based on the patient's heart condition.  The physician sets the pacemaker at a minimum rate, so when the patient's heart rate drops below that rate, the device produces an impulse.  That impulse then passes through the lead into the heart muscle causing the heat muscle to contract, creating a heartbeat. 

Is a Pacemaker implant procedure safe?

Generally the pacemaker implant procedure is very safe.  This procedure itself is invasive so there are risks, but precautions are taken to reduce these risks.  Patients are encouraged to discuss any of their concerns about the risks and benefits of this procedure with their cardiologist.

How is a Pacemaker implantation performed?

The permanent pacemaker implant procedure usually requires an overnight stay at the hospital.  Before the procedure begins, a nurse will help the patient get ready.  An IV will be placed in a vein in the patient's arm or hand, which is used to dispense medications and fluids during the procedure.  The patient is to not be asleep during the procedure so the medications given through the IV are used to make the patient feel relaxed and sleepy.  The patient is monitored throughout the entire procedure.

Anesthetic is given locally to numb the location of where the placement is to be made of the permanent pacemaker.  A small opening is made in the shoulder area, usually on the left side, beneath the clavicle.  The lead(s) is/are inserted through an incision into a vein and then channeled through to the heart with the assistance of a fluoroscopy machine.  A lead tip is connected to the heart muscle and the other end is attached to the pulse generator.  The pulse generator contains the battery and electronics which is placed in a small pocket created under the skin in the upper chest and sutured in to place.  The procedure usually lasts about 2 to 5 hours and an overnight stay is generally required.  The patient generally will be allowed to go home the day after the implantation. 

How long does the Pacemaker battery work for?

After patient has had the pacemaker implantation it should only pace the heart when the heart rate falls below the pacer set rate.  The battery lasts 3 to 12 years with an average of 5 to 7 years and should be checked regularly by pacer technologists.  The pulse generator can be easily replaced, requiring only a few hours in the hospital.