Pacemaker Implantation - Who Needs It and How It Works | Dr. Mahesh Kharade

What is a Pacemaker?

• Single-chamber pacemaker – Stimulates either the right atrium or right ventricle.
• Dual-chamber pacemaker – Regulates both the atrium and ventricle for better coordination.
• Biventricular pacemaker (Cardiac Resynchronization Therapy - CRT) – Used for heart failure patients to synchronize the ventricles.

Who Needs a Pacemaker?

• When the heart beats too slowly, it fails to pump enough oxygen-rich blood to the body.
• Symptoms: Fatigue, dizziness, fainting, and confusion.

• A condition where electrical signals from the atria (upper chambers) to the ventricles (lower chambers) are delayed or completely blocked.
• Can be congenital or develop due to aging, heart disease, or previous heart surgery.

• The sinus node (heart’s natural pacemaker) fails to function properly, leading to irregular heart rhythms.
• Can cause a mix of slow and fast heart rates.

• Some patients with AFib may experience an abnormally slow heart rate, requiring pacemaker support.

• In some cases of severe heart failure, a specialized pacemaker (CRT) helps improve heart function by coordinating the heart’s contractions.

How is Pacemaker Implantation Done?

• The patient undergoes tests like ECG, echocardiogram, and Holter monitoring to evaluate heart function.
• Blood tests and imaging are performed to ensure the patient is fit for the procedure.

• Pacemaker implantation is a minimally invasive procedure performed under local anesthesia.
• A small incision is made near the collarbone, and thin wires (leads) are guided through a vein into the heart chambers.
• The leads are connected to the pacemaker, which is then placed under the skin.
• The pacemaker is programmed to deliver electrical signals based on the patient’s heart condition.
• The procedure typically takes 1–2 hours, and most patients are discharged within a day.

• Patients can resume normal activities in a few days but should avoid heavy lifting and strenuous activities for a few weeks.
• Regular follow-ups are essential to check battery life and pacemaker function.
• Modern pacemakers last 5–15 years before requiring a battery replacement.

Benefits of Pacemaker Implantation

• Restores normal heart rhythm, preventing slow heart rates.
• Reduces symptoms such as dizziness, fatigue, and fainting.
• Improves heart efficiency in patients with heart failure.
• Enhances quality of life by allowing patients to perform daily activities without limitations.
• Lifesaving intervention for individuals at risk of sudden cardiac arrest due to bradycardia.

Are There Any Risks?

• Infection at the implantation site.
• Lead displacement requiring repositioning.
• Allergic reactions to anesthesia or contrast dye.
• Rare complications like blood clots, lung collapse, or heart perforation.

Living with a Pacemaker: Important Considerations

• Patients should inform healthcare providers and carry a pacemaker identification card.
• Avoid MRI scans unless the pacemaker is MRI-compatible.

• Modern pacemakers are well-shielded, but strong magnetic fields (e.g., airport security scanners, industrial equipment) should be avoided.
• Mobile phones should be kept at least 6 inches away from the pacemaker.

• Most daily activities, including light exercise, are safe.
• Contact sports should be avoided to prevent damage to the pacemaker site.

• Follow-up visits every 3-6 months to monitor pacemaker function and battery life.