What is Pacemaker Implantation?

Pacemaker implantation, as the name implies, is a surgical procedure in which a small electronic device called a pacemaker is implanted in your chest. The pacemaker sends electrical impulses to the heart to make it keep beating at a normal rate.

For people who have a life-threatening slow heart rate, a pacemaker implantation is a life-saving procedure. Pacemaker implantation is one of the commonest surgical procedures done on the heart.

Why is a Pacemaker Implantation Done?

The heart is a bag of muscle which beats and pumps spontaneously as a result of electrical impulses generated by a group of cells which make up the sinoatrial node. This node connects to all parts of the heart via a network of fibres.

If the heart’s electrical impulses are generated at a slow rate, the heart would beat and pump slowly and this may be very dangerous. This condition is called bradycardia. In other cases, the impulses may not be able to move from the sinoatrial node to the conducting fibres, this condition is called heart block. The node itself might be generating electrical impulses poorly.

Patients with any of these disease conditions would be needing a pacemaker to ensure the heart’s electrical impulses are artificially generated to keep the heart working fine.

How does Pacemaker Implantation Work?

The pacemaker is a small device that consists of the pulse generator and one or more wires called leads which are attached to the heart. The pulse generator sends out electrical signals based on the rate of your heartbeat through the lead wires to the heart to correct an abnormal beat. It would not generate signals if your heart is beating at a normal steady rate.

How is a Pacemaker Implantation Done?

A pacemaker implantation is a simple procedure which is done under local anaesthesia, meaning that you would be awake the whole time as you would only be given a numbing medicine at the site where you would have an incision.

A small incision is made below your clavicle to gain access to a large vein in your neck. Then a needle is inserted into the vein, with a guide wire advanced over it. When the tip of the guide wire reaches the targeted position in your heart, the needle is removed leaving the guide wire in place.

A sheath containing an electric lead is inserted through the guide wire to be positioned in one chamber of the heart. You might require two leads, with the second one positioned in the opposite chamber of your heart.

Once the leads have been well positioned, their ends are attached to the chest muscle. The pacemaker is subsequently connected to the leads and implanted and secured beneath the skin over the chest muscle or beneath the muscle.

After successful implantation of the pacemaker, the incision is sutured and dressed. Your doctor will recommend a chest x-ray following the procedure, to confirm that the leads have been well positioned.

Pacemaker implantation usually takes an hour, and after the procedure you would stay in the hospital under close monitoring till the next day.

Your doctor would advise you not to engage is stressful physical activities for four to six weeks after the implantation. Furthermore, you would be asked to come for routine checks to see how well the pacemaker is working.

What Risks are Associated with Pacemaker Implantation?

It is generally a safe procedure. The only concern is that a pacemaker might malfunction, needing replacement or surgery.