A pacemaker is one of the best-known medical devices used by an electrophysiologist. Pacemakers are small devices connected to the heart that monitor its rhythm and offer a little help when the rhythm slows down too much. In other words, the pacemaker helps to keep this rhythm appropriate by initializing an electrical signal when the heart would not have done so naturally. Millions of Americans require a pacemaker to keep their heart in rhythm. Most people that require a pacemaker are of advanced age and have experienced some degree of cardiovascular disease or heart failure.
A pacemaker is implanted in a very straightforward manner. To start, some patients may receive a temporary pacemaker. This may be used as a test prior to the implantation of a permanent pacemaker or may be transitory during treatment for another cardiovascular condition. On this page we will discuss the implantation of a permanent pacemaker.
The implantation process
To begin, leads or wires are threaded through veins and into the heart. These wires are connected to the appropriate chambers of the heart. Some pacemakers are single lead, while others may be dual. In either case, the leads are implanted in the same way. The other end of the lead is connected to a pulse generator or battery that allows for the pacemaker to fire its electrical signal. The pacemaker battery is implanted just under the skin somewhere on the upper chest or in the abdomen. A small incision is made, and a pouch is created for the battery to sit snugly.
Prior to the incision being closed, Dr. Tordini will test the pacemaker to ensure it is functioning correctly. Over time, the pacemaker can be adjusted based on the patient’s needs and prior history.
Will I feel the pacemaker?
Many patients will feel the pacemaker for a few days after implantation. However, the pacemaker does become part of your normal routine and you quickly forget that it’s even there. You will not feel the pacemaker pacing your heart. Typically, the only effects of the pacemaker that you feel revolve around the improved lifestyle that it provides. You will, however, be able to feel the pacemaker under the skin depending on where it is implanted. Traditional pacemakers, while much smaller than they were even a decade ago can’t be hidden completely. However, some patients will also have the option for a leadless pacemaker which is implanted directly into the heart and cannot be felt.
Is my pacemaker MRI safe?
Yes. All modern pacemakers are MRI safe and should be just fine in case you need advanced imaging. However, it is always important to tell your medical team and the MRI technician that you have a pacemaker. You will also be given a device card for when you are traveling. With that said, it is also prudent to avoid any devices or appliances that may cause interference with your pacemaker. Typically, we suggest that you do not keep your phone in your shirt or jacket pocket, near your pacemaker, and rather keep it stored in your trouser pocket. Similarly, do not spend too much time near appliances like microwaves that can cause significant interference while they function.
How long will the pacemaker battery last?
This will largely depend on how much work the pacemaker has to perform to keep the heart paced properly. Most pacemakers today will last for upwards of 12 years. We will be alerted to the pacemaker running out of batteries during a routine follow up and can schedule the replacement of the pulse generator. Replacing the battery is relatively straightforward and simply involves removing the old battery from the pouch created in the chest or abdomen and replacing it with a similar device.