Permanent Pacemaker Implantation

What is Permanent Pacemaker?

A permanent pacemaker is a small electronic device implanted in the chest to regulate the heartbeat. It helps manage heart rhythm disorders, ensuring the heart beats at a normal and steady rate. Pacemakers are commonly used for patients with bradycardia (slow heart rate), heart block, or other conduction system abnormalities.

Doctors recommend pacemaker implantation for various heart conditions, including:

Bradycardia: A slow heart rate that can cause dizziness, fatigue, and fainting.
Heart Block: A condition where electrical signals from the atria to the ventricles are delayed or blocked.
Atrial Fibrillation with Slow Heart Rate: When medications used to treat atrial fibrillation slow the heart too much.

Types of Permanent Pacemakers

Single-Chamber Pacemaker: Sends electrical signals to either the right atrium or right ventricle.
Dual-Chamber Pacemaker: Controls both the right atrium and right ventricle for better heart coordination.
Biventricular Pacemaker (CRT – Cardiac Resynchronization Therapy): Used for heart failure patients to synchronize both ventricles.

How is the Pacemaker Implanted?

1. Preparation Before the Procedure

Blood tests and an ECG are done to assess heart function.
Medications like blood thinners may be adjusted before surgery.
The patient is advised to fast for 6-8 hours before the procedure.

2. The Implantation Procedure

The procedure is performed under local anesthesia and sedation.
A small incision (about 2 inches) is made below the collarbone.
Leads (thin wires) are inserted through a vein into the heart chambers, guided by X-ray imaging.
The pacemaker device is placed under the skin or chest muscle, and the leads are connected to it.
The device is programmed to ensure proper pacing, and the incision is closed with stitches.

3. Recovery After the Procedure

Patients are monitored in the hospital for a few hours or overnight.
Mild soreness or swelling at the incision site is normal.
Most patients can return home within 24 hours and resume light activities.

Precautions After Pacemaker Implantation

Avoid Heavy Lifting & Strenuous Activities: Do not lift heavy objects or raise your arm on the side of the implant for 4-6 weeks to allow healing.
Keep the Incision Site Clean & Dry: Follow wound care instructions to prevent infection.
Avoid Strong Electromagnetic Fields: Stay away from MRI machines, strong magnets, and electrical equipment that may interfere with the pacemaker.
Carry a Pacemaker ID Card: This helps medical professionals provide appropriate treatment in emergencies.
Regular Follow-Ups: Periodic check-ups are essential to monitor pacemaker function and battery life.
Be Aware of Symptoms: Report dizziness, fatigue, palpitations, or swelling to your doctor immediately.

Lifespan & Maintenance of a Pacemaker

Battery Life

The battery of a pacemaker typically lasts between 5 to 15 years, depending on usage and device type. Regular check-ups help monitor battery status.

Routine Check-ups

Patients should visit their doctor every 3 to 6 months to assess pacemaker function, adjust settings if needed, and check battery levels.

Pacemaker Replacement

When the battery nears depletion, a minor surgical procedure is performed to replace the pacemaker while keeping the existing leads if they are in good condition.

Avoid Electromagnetic Interference

Strong electromagnetic fields, such as MRI machines, airport security scanners, and high-voltage power lines, can interfere with pacemaker function. Always inform medical personnel about your device.

Physical Activity Precautions

While most daily activities are safe, high-impact sports and heavy lifting should be avoided to prevent damage to the pacemaker leads.

Monitoring Symptoms

Patients should be aware of signs like dizziness, fatigue, or irregular heartbeats, which may indicate pacemaker malfunction and require immediate medical attention.