Pacemaker Implantation

What is a pacemaker?

A pacemaker is a small device that sends electrical pulses to your heart to help it beat at a normal rate and rhythm. It is used if you have an abnormal heart rhythm, called an arrhythmia, that beats too slowly, too quickly, or irregularly. It can also help your heart chambers beat in sync so that your heart can pump blood more efficiently to your body if you have heart failure.

Pacemakers are matchbox sized and weigh about 20 to 50 grams. They consist of a box that generates pulses and one, two, or three electrode leads that deliver electrical impulses to and from your heart, contained in a metal case.

The type of pacemaker you have will depend on your condition. Pacemakers with one lead are called single-chamber pacemakers and carry electrical impulses to the right ventricle of your heart. Those with two leads are dual-chamber pacemakers. They carry electrical impulses to the right ventricle and the right atrium of your heart and help to control the timing of contractions between the two chambers. Devices with three leads are called bi-ventricular or cardiac resynchronisation therapy pacemakers and are used if you have heart failure or heartbeat problems. They stimulate your right and left lower heart chambers to work together in a coordinated way and make your heart beat more efficiently.

Most pacemakers are rate responsive. This means that they work on demand and are programmed to adjust their electrical impulse rate in response to your body's needs. So, if your pacemaker senses that your heart has missed a beat or it is beating too slowly, it sends signals at a steady rate. It does not send out any signals if it senses that your heart is beating normally by itself. Pacemakers usually have a sensor that recognises your body movement or your breathing rate and they can speed up the impulses when you are active.

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