A pacemaker is a device implanted under the skin on the chest wall to provide a backup if the heart rate becomes too low. This device is composed of a generator (containing a battery with a lifespan of about 7 to 10 years) and leads which sense when the heart has gone too slow and can provide backup pacing by stimulating the heart.
Your doctor will have recommended a pacemaker when the heart is beating slowly and causing symptoms which are usually dizziness or collapses but can include tiredness. Sometimes you may not have symptoms but your doctor may have found evidence of severe problems with the conducting system which places you at high risk of collapses in the future.
You will be asked to lie on a table in the special operating theatre which has an X-ray machine. Your heart rhythm will be checked by adhesive stickers on your chest which is linked up to the monitoring equipment. You will have a blood pressure cuff on your arm and a saturation probe on your finger.
Preventing infection is important and some drapes (disposable sheets) will be placed over the upper half of your body after cold cleaning solution has been applied. Local anaesthetic will be injected under the collarbone and you may also be given some medication to make you sleepy (sedative).
A small cut will be made under the collarbone and the leads of the pacemaker will be fed round to the heart under X-ray guidance via a large vein which sits under the clavicle. You shouldn’t feel any chest pain but may get some bumping feeling in your chest whilst the leads are being positioned. The pacemaker will then be inserted into a small pocket under the incision and it will be closed with stitches to make a neat scar.
The physiologists will check the pacemaker function and set up the parameters so that it is working optimally. This is done via a programmer that communicates with the pacemaker through the skin. You will need your pacemaker checking a few weeks afterwards and then at least annually after that, though this can often now be done remotely.
The benefits are a reduction in the chance of dying from a dangerous heart rhythm.
The risks are low and most people do not have any problems with the procedure. There is a small chance (1%) of damage to the lung or blood vessels around the heart which may require drainage. There is also a small chance of one of the leads becoming dislodged which may require a second procedure to relocate it. There is also a small chance of bleeding or infection and this may require and additional procedure.
A pacemaker can transform symptoms and prevent injury or death but requires careful evaluation and planning. Our cardiologists are available for consultation on any day of the week and weekends as well.
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