A pacemaker is a small electronic device approximately the size of a deck of cards that regulates the heart beat by sending electrical signals to the heart. It mimics the heart and helps it beat more normally. A pacemaker is necessary when problems develop in the heart's electrical tissue causing the heart to beat too slow or too fast. When the heart is not beating fast enough to pump an adequate amount of blood to the body, symptoms such as dizziness, fainting spells, blurred vision or shortness of breath can occur. A permanent pacemaker is needed when these conditions cannot be controlled by medications. The pacemaker device consists of two parts:
- The battery unit is a small metal case that contains the power source and regulates how often signals are sent to the heart.
- The wire carries electrical messages back and forth between the heart and the pacemaker.
A permanent pacemaker is inserted in the operating room while the patient is sedated. The pacemaker battery unit is usually placed just under the skin in the upper chest. The pacemaker wire is threaded through a vein into the heart muscle.
After the Procedure
A small dressing will be placed over the incision site and sutures. The patient is admitted to the hospital for about 24 hours so he can be closely monitored. The patient's pulse, blood pressure, and incision site will be checked frequently.
While recovering, inspect the incision daily for signs of infection (redness, drainage, swelling, warmth, or pain). After the recovery, watch for difficulty breathing, dizziness or fainting spells, prolonged weakness or fatigue, swelling in the legs, ankles, arms, or wrists, or chest pain. Notify the doctor immediately if any of these signs occur.
The patient should learn to take his pulse, and call the doctor if his heart rate is much higher or lower than the programmed rate of his pacemaker. This should be done first thing in the morning before getting out of bed.
The patient should wear an ID bracelet/necklace and carry an identification card that lists the pacemaker's name, manufacturer's model and serial number, date implanted, and the name and telephone number of his doctor.
The patient will be required to have routine follow-up appointments for pacemaker function or transmit information from the pacemaker to the doctor over the phone with special equipment. This information will keep the doctor informed about how the pacemaker is operating.
When it is time for the battery to be replaced, an appointment will be scheduled for you. Replacement of only the lithium battery would break the pacemaker's seal. Therefore, when replacement is necessary, a small incision is made, the leads are disconnected and the entire pulse generator is replaced with a new one. Generally, this is much quicker than the initial implant.