Pacemaker Implantation

A pacemaker insertion is the implantation of a small electronic device that is usually placed in the chest (just below the collarbone) to help regulate slow electrical problems with the heart. A pacemaker may be recommended to ensure that the heartbeat does not slow to a dangerously low rate.

The pacemaker sends electrical pulses to your heart to keep it beating regularly and not too slowly.

Having a pacemaker can significantly improve your quality of life if you have problems with a slow heart rate. The device can be lifesaving for some people.

Types of pacemakers -

Your doctor will decide what type of pacemaker you need based on your heart condition. Your doctor also determines the minimum rate (lowest heart rate) to set your pacemaker.

• Leadless Pacemaker – Self-contained device without connecting leads (wires) and generator

• Biventricular Pacemaker – also called cardiac resynchronization therapy (CRT)

Why do I need a pacemaker?

The heart is essentially a pump made of muscle, which is controlled by electrical signals.

These signals can become disrupted for several reasons, which can lead to a number of potentially dangerous heart conditions, such as:

• an abnormally slow heartbeat (bradycardia)

• an abnormally fast heartbeat (tachycardia)

• heart block (where your heart beats irregularly because the electrical signals that control your heartbeat aren’t transmitted properly)

• cardiac arrest (when a problem with the heart’s electrical signals cause the heart to stop beating altogether)

How is a pacemaker fitted?

Having a pacemaker implanted is a relatively straightforward process.

• It’s usually carried out under local anaesthetic, which means you’ll be awake during the procedure.

• The generator is usually placed under the skin near the collarbone on the left side of the chest.

The generator is attached to a wire that’s guided through a blood vessel to the heart.

• The procedure usually takes about an hour, and most people are able to leave hospital on the same day or a day after surgery.

What are the risks of the procedure?

Possible risks of pacemaker include, but are not limited to, the following:

• Bleeding from the incision or catheter insertion site

• Damage to the vessel at the catheter insertion site

• Infection of the incision or catheter site

• Pneumothorax. If the nearby lung is inadvertently punctured during the procedure, leaking air becomes trapped in the pleural space (outside the lung but within the chest wall); this can cause breathing difficulties and in extreme cases may cause the lung to collapse.