Your heart beat is usually generated by the heart’s electrical system (conduction system), between 50 and 180 beats per minute (bpm) depending on your level of physical activity. When the heart beat is too slow, or fails to increase on exertion a pacemaker may be required.

What is a Pacemaker?

A pacemaker is a small device (about the size of two silver dollars stuck together) placed under the skin of your chest just below the collar bone. The pacemaker records your heart beat continuously, recording any racing heart beats or arrhythmias, and transmitting an electrical signal to the heart when the heart beat falls below 50-60 bpm to make it beat.

Dizziness, fainting spells, shortness of breath, and blurred vision may be symptoms of a heart rhythm disturbance.

A pacemaker has a pulse generator (battery or box) that sits under the skin below your collarbone, and 1-3 pacing leads that are inserted through the arm veins into the heart. The choice of pacemaker type depends on your symptoms and underlying heart disease. Most pacemakers have one or two leads, placed in the top and bottom chambers of the heart. Occasionally a third lead is placed over the left side of the heart, to assist the treatment heart failure.

The pacemaker battery lasts about 5-8 years, and will be replaced through the original incision at that time. The leads remain in position lifelong.

Pacemaker Insertion Procedure

Having a pacemaker implant is not considered major surgery. The procedure takes only one to two hours and is performed under local anesthesia with the patient sedated, but awake.

The surgeon makes a three to four inch incision in the upper chest area and a small pocket is made under the skin over a vein. The pacemaker will rest in this pocket. As the physician watches progress on a monitor, the wires are guided through a vein into the heart’s chambers. The electrode rests directly against the inner wall of the heart. The battery/timer is attached to the wires and placed in the pocket under the skin.

Most patients realize dramatic improvement in their well being after the pacemaker is inserted. Your pacemaker may require some fine tuning, and medications may be adjusted, but chances are excellent that you will feel a lot better.