A pacemaker is a small device that is implanted under the skin (most often in the shoulder area just under the collarbone) it ends electrical signals to start or regulate slow heartbeat. Some are permanent (internal) and some are temporary (external).They can replace a defective natural pacemaker or blocked pathway.
Pacemakers can be surgically placed into the chest (a permanent pacemaker) through a small incision, or they can be worn outside the body (a temporary pacemaker) and attached to the heart through a wire that is threaded through a neck vein. Temporary pacemakers are used only while a person is in the hospital.
Types of pacemakers
There are several kinds of permanent pacemakers, each designed to meet a different need. They include : -
Demand pacemakers, which monitor the heart rate and discharge electricity only when the heart rate falls below programmed minimum or misses a beat.
Fixed-rate pacemakers, which discharge a steady stream of electrical impulses, regardless of the underlying heart rate.
Rate-responsive pacemakers, which monitor various physical changes in the body (e.g., respiration, physical activity) and change the rate of discharge accordingly.
There are two basic types of pacemakers : -
Single-chamber pacemakers stimulate one chamber of the heart, either an atrium or more often a ventricle.
Dual-chamber pacemakers send electrical impulses to both the atrium and the ventricle and pace both chambers. A dual-chamber pacemaker synchronizes the rhythm of the atria and ventricles in a pattern that closely resembles the natural heartbeat. Dual-chamber pacemakers are usually used to treat a slow heart rate.
Components of Pacemakers
A pulse generator which has a sealed lithium battery and an electronic circuitry package. The pulse generator produces the electrical signals that make the capability to receive and respond to signals that are sent by the heart itself.
One or more wires (also called leads).Leads are insulated flexible wires that conduct electrical signals to the heart from the pulse generator. The leads also relay signals from the heart to the pulse generator. One end of the lead is attached to the pulse generator and the electrode end of the lead is positioned in the atrium (upper chamber of the heart) or in the right ventricle (lower chamber of the heart).In the case of the biventricular pacemaker leads are placed in both ventricles.
Electrodes on each lead.
Procedure of Implanting Pacemaker
This procedure is done under local anesthesia and is usually an outpatient procedure.
A small incision is made just under the collarbone. The pacemaker is inserted into the heart through a blood vessel which runs under the collarbone. Once the lead is in place it is tested to make sure it is in the right place and it’s functional. The lead is then attached to the generator, which is placed just under the skin through the incisions made earlier. Once the procedure has been completed the patient goes through a recovery period of several hours and often is allowed to go home the day of the procedure.
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