Pacemaker implantation is the insertion of a small electronic device that is placed to help regulate electrical problems in the heart. A pacemaker may be recommended to ensure that the heartbeat maintains a healthy rate and does not fall below a certain number that could be considered dangerous or life-threatening. Pacemakers treat low heart rate problems (bradycardia) but not high heart rate problems (tachycardia). There are 2 main types of pacemakers, a traditional pacemaker with leads and a smaller or “leadless” pacemaker. The physicians at Cardiovascular ASC, LLC are well-versed in all types of pacemaker implantations.
Why Pacemaker Implantation is Performed
A traditional pacemaker with leads is a small device that’s placed under the skin of your chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate. Pacemakers are used to treat heart rhythms that are too slow. These abnormal heart rhythms are called bradycardias.
Pacemakers can relieve some symptoms related to bradycardia, such as fatigue (tiredness) and fainting. A pacemaker can help a person who has an abnormal heart rhythm resume a more active lifestyle.
A pacemaker has two parts:
- Pulse Generator: A small metal container that houses a battery and the electrical circuitry that controls the rate of electrical pulses sent to the heart.
- Leads or Electrodes: One, two, or three flexible, insulated wires are each placed in one or more chambers of the heart and deliver the electrical pulses to adjust the heart rate
- Some newer pacemakers don’t require leads. These devices are called Leadless Pacemakers.
Types of Pacemakers
There are different types of pacemakers used to treat different types of arrhythmias.
- Single Chamber Pacemaker: Carries electrical impulses to the right ventricle of your heart.
- Dual-chamber pacemaker: Carries electrical impulses to the right ventricle and the right atrium of your heart to help control the timing of contractions between the two chambers.
- Biventricular Pacemaker: Stimulates both of the lower heart chambers (the right and left ventricles) to make the heart beat more efficiently.
- Leadless Pacemaker: A self-contained device that is inserted directly into the muscle of the right ventricle of the heart. Used for patients with bradycardia who only need pacing on 1 of the heart chambers, or who will only require pacing on rare, intermittent occasions.
What to Expect
Pacemaker implantation typically takes 1-2 hours although you can expect to be under observation in recovery for 3-4 hours after the procedure.
Before the Procedure
After checking in to the Cardiovascular ASC, you will be taken to a patient room where a specialist will insert an IV to administer a sedative. The amount of sedation needed for the procedure depends on your specific health conditions. You may be being fully awake or lightly sedated (conscious sedation).
During the Procedure
If a pacemaker with leads is being implanted, the leads are inserted into a major vein under or near your collarbone and guided to your heart with the help of X-ray images. One end of each wire is attached to the appropriate position in your heart. The other end is attached to the pulse generator, which is usually implanted under the skin beneath your collarbone.
A leadless pacemaker is smaller and typically requires less invasive surgery to implant the device. The pulse generator and other pacemaker parts are contained in a single capsule. The doctor inserts a catheter into a vein in the groin and then guides the pacemaker through the catheter to the proper position in the heart.
After the Procedure
After the pacemaker implantation, the device will be programmed to fit your heart rhythm needs. You’ll need to have someone drive you home from the ASC after the procedure.
Aftercare and Recovery
Follow the aftercare and recovery instructions provided by your doctor. You may need to avoid vigorous exercise or heavy lifting for about a month. Avoid putting pressure on the area where the pacemaker was implanted. The side that the pacemaker is implanted on should not be raised significantly for 4 weeks. You will be discharged home with written specific instructions post-procedure. If you have pain in the area of insertion, consult your doctor about what kind of medication you can take to manage the discomfort.
If at any point after pacemaker implantation you gain weight, your legs or ankles swell, or if you faint or get dizzy, contact your doctor as soon as possible.
After a pacemaker insertion, regularly scheduled appointments will be made to ensure that the wound is healing well and that the pacemaker is functioning properly. A complete pacemaker check should be done six weeks after your pacemaker is implanted. This check is very important because adjustments will be made that can prolong the life of your pacemaker. Sometimes this check is done remotely from your home using a remote transmitter that the pacemaker company will provide without the need for you to visit the office. Other times the pacemaker needs to be check in the office by a technician. After that, your pacemaker should be checked every six to twelve months to evaluate battery function.
Your pacemaker’s battery should last 7 to 15 years. When the battery stops working, you’ll need pacemaker exchange [link to pacemaker exchange page] surgery to replace it. The procedure to change your pacemaker’s battery is often quicker and requires less recovery time than the procedure to implant your pacemaker. Like with any type of technology there is always a very small but real chance of device or lead malfunction in the future which may lead to either device change or revision.
Contact ASC, LLC
At Cardiovascular ASC, LLC our board-certified cardiologists and electrophysiologists utilize advanced technologies to deliver the highest quality care in a cost-effective setting. Call Cardiovascular ASC, LLC at 727-449-9891 to learn more about our facility and the services we provide.