A pacemaker is a small device that is implanted under the skin (most often in the shoulder area just under the collarbone) it ends electrical signals to start or regulate slow heartbeat. Some are permanent (internal) and some are temporary (external).They can replace a defective natural pacemaker or blocked pathway.
Pacemakers can be surgically placed into the chest (a permanent pacemaker) through a small incision, or they can be worn outside the body (a temporary pacemaker) and attached to the heart through a wire that is threaded through a neck vein. Temporary pacemakers are used only while a person is in the hospital.
A temporary pacemaker is an "artificial" pacemaker that takes the place of or overrides a faulty SA node. The device is inserted by threading a lead or wire through a vein into the right ventricle of the patient's heart. At the other end, outside of the patient's body, the wire is attached to a power source which stimulates the heart to contract.
Temporary pacemakers are often used in emergency situations to keep a person's heart beat stable until a permanent pacemaker can be inserted. It also may be used after a heart attack to keep the heart rhythm normal until the extent of tissue damage can be established. Patients on temporary pacemakers require constant monitoring.
Types of pacemakers
There are several kinds of permanent pacemakers, each designed to meet a different need. They include : -
Demand pacemakers, which monitor the heart rate and discharge electricity only when the heart rate falls below a > programmed minimum or misses a beat.
Fixed-rate pacemakers, which discharge a steady stream of electrical impulses, regardless of the underlying heart rate.
Rate-responsive pacemakers, which monitor various physical changes in the body (e.g., respiration, physical activity) and change the rate of discharge accordingly.
There are two basic types of pacemakers : -
Single-chamber pacemakers stimulate one chamber of the heart, either an atrium or more often a ventricle.
Dual-chamber pacemakers send electrical impulses to both the atrium and the ventricle and pace both chambers. A dual-chamber pacemaker synchronizes the rhythm of the atria and ventricles in a pattern that closely resembles the natural heartbeat. Dual-chamber pacemakers are usually used to treat a slow heart rate.
Who Needs Pacemaker ?
Doctor recommends pacemakers to patients for a number of reasons. The most common reason is when a patient's heart is beating too slowly or there are long pauses between heart beats.
A pacemaker may be helpful : -
A pacemaker is used when the heart beats to slowly (bradycardia) or has other abnormalrythmias (arrhythmias).In some cases pacemakers are also used to treat the symptoms of heart failure.
The electrical signals between your hearts upper and lower chambers are partially or completely blocked or slowed down (this is called heart block). Aging damage to the heart from a heart attack or other heart condition can prevent electrical signals from reaching all the hearts chambers
You have had a medical procedure to treat arrhythmias called Atrial fibrillation. A pacemaker can help regulate your heart beat after the procedure.
You have heart muscles problems that cause electrical signals to travel through your heart muscles too slow(your pacemaker will provide cardiac resynchronization therapy for this problem)
Aging or heart disease damages your sinus nodes ability t set the correct pace for your heartbeat. Such damage can make your heart beat too slow or it can cause long pauses between heart beats. The damage also can cause your heart rhythm to alternate between slow and fast.
Components of Pacemakers
A pulse generator which has a sealed lithium battery and an electronic circuitry package. The pulse generator produces the electrical signals that make the capability to receive and respond to signals that are sent by the heart itself.
One or more wires (also called leads).Leads are insulated flexible wires that conduct electrical signals to the heart from the pulse generator. The leads also relay signals from the heart to the pulse generator. One end of the lead is attached to the pulse generator and the electrode end of the lead is positioned in the atrium (upper chamber of the heart) or in the right ventricle (lower chamber of the heart).In the case of the biventricular pacemaker leads are placed in both ventricles.
Electrodes on each lead.
Procedure of Implanting Pacemaker
This procedure is done under local anesthesia and is usually an outpatient procedure.
A small incision is made just under the collarbone. The pacemaker is inserted into the heart through a blood vessel which runs under the collarbone. Once the lead is in place it is tested to make sure it is in the right place and it's functional. The lead is then attached to the generator, which is placed just under the skin through the incisions made earlier. Once the procedure has been completed the patient goes through a recovery period of several hours and often is allowed to go home the day of the procedure.
What Happens After I Leave the Hospital ?
You must remember several things in caring for yourself after you leave the hospital. Sometimes antibiotics are prescribed and may he taken for several days. Check your temperature twice throughout the day to determine if it is elevated (possibly indicating infection). Change the dressing over the pacemaker daily, but do not take off the steri-strips that are on the incision. Inspect the incision for redness, swelling or drainage and replace the dressing with a clean, dry bandage. Do not cleanse or rub the incision with anything.
If you develop redness, swelling, drainage, increased wound tenderness or an elevated temperature, please notify the local physician on We Care immediately.After the third day, you may shower and allow the incision to get wet, hut do not scrub the area, and keep the force of the water from spraying directly on the incision. The steri-strips will start to loosen and usually come off seven to 10 days after surgery.
You should have a follow-up appointment with your physician within seven to 10 days of surgery. Do not lift or move the arm on the side of the pacemaker above your head for two weeks- Once you see your physician he or she will assist you with guidelines for increasing your activity. It may take rime to build up your strength, but you should increase your activity.
Will My Day-to-Day Life Change ?
Know the rate at which your pacemaker has been set by your doctor. Your pulse may be faster than the preset rate, but it should never be slower than this rate. A nurse will help you practice taking your pulse before you leave the hospital.
You will receive a pacemaker identification (ID) card while you are in the hospital, or in the mail after you go home. You should carry this ID at all times. Most electrical and mechanical devices will not interfere with your pacemaker. In general, you may use any appliance or go anywhere except into areas where strong electrical interference may exist. Always tell any doctor or dentist who treats you that you have a pacemaker
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