Who Needs a Pacemaker?

Pacemakers are small, battery-operated devices most commonly used to treat patients with a heart rate that is too slow (a condition known as bradycardia) and heart block, which occurs if an electrical signal is slowed or disrupted as it moves through the heart. This can happen as part of the aging process, from damage to the heart due to heart attack, or any condition that disrupts the heart's electrical activity. Pacemakers can also be used to treat individuals who have congestive heart failure and hypertrophic cardiomyopathy.

Patients who undergo an AV (atrioventricular) node ablation to treat atrial fibrillation, an irregular heartbeat, are also implanted with a pacemaker to help maintain a normal heart rate.   

How Does it Work?

A pacemaker replaces the heart’s natural pacing functions and works by receiving and sending electrical signals to and from the heart to regulate the heart rate. It is typically permanently implanted in the upper chest while the patient is under conscious sedation with local anesthesia. Wires (or leads) connected to the pacemaker are threaded through the veins and implanted into the heart muscle. These wires send tiny electric charges (which cannot be felt) from the pacemaker to the heart as necessary (for example, if the heart is beating too slowly).

A pacemaker may have one, two or three leads, depending on the specific heart condition. All pacemakers have sensors that detect motion and some can even detect breathing. These sensors signal the pacemaker to increase the heart rate during exertion (e.g., exercise) to meet the body’s need for more blood and oxygen.

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