What does it do?

A pacemaker monitors your heart rate and sends small and painless electrical impulses to the right ventricle of your heart to start each heart beat only when needed. You may need a pacemaker if your heart beats too slow and it cannot be controlled by medication.

Pacemakers today are small metal devices about the size of a small pocket watch, which contain the computer and battery and one, two or three flexible electrode leads (coated wires). They are not obviously visible so you, along with others, should find that you are not aware of it on a daily basis.

Where does it go and how is it put in place?

A pacemaker is usually implanted with a local anaesthetic, just under your collarbone with leads (coated wires) coming from it that are positioned in your heart. The procedure usually takes 30-60 minutes.

The electrode lead is inserted into a vein at the shoulder or the base of the neck. The cardiologist guides the lead into the correct chamber of the heart, checking its position on an X-ray screen, and secures it in position with a stitch at your shoulder. The lead is then connected to the pacemaker and the pacemaker is fitted into a small 'pocket', or space, between the skin and the chest muscle. The amount of electrical energy needed to stimulate the heart to contract is then tested and the pacemaker is adjusted.

After the procedure

After your pacemaker has been fitted, you may feel some pain or discomfort and there may be some bruising at the site of the pacemaker but these problems usually disappear in a few days. Most people are walking around later the same day and resume normal activities again within 1 week.

The functioning and battery life of your pacemaker must be checked regularly at a pacemaker clinic. Depending on the device implanted, a telemonitoring follow up  may be proposed to monitor your pacemaker, allowing rapid identification of heart rhythm disturbance and technical dysfunction and may improve your care and reduce the need for pacemaker clinic visits.

If the battery must be replaced, only the device needs to be replaced (not the leads). The battery usually lasts between 6 and 10 years before it needs to be replaced.

It is important that you let any doctors or dentists know that you have a pacemaker before going for any procedures. Although most medical and dental procedures are unlikely to interfere with the functioning of your device, some may require precautionary measures that minimise any interference.

Pacemakers may sometimes be detected by airport security machines, but the functioning of the device is rarely affected, so if you have a pacemaker you should always inform the security personnel.

Two types of pacemakers are used:
Single-chamber pacemaker
Single-chamber pacemaker
Dual-chamber pacemaker
Dual-chamber pacemaker

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