A permanent pacemaker is an electronic device that is permanently implanted into a person's chest to help regulate his heartbeat. It is generally surgically implanted into people who have had heart problems such as arrhythmias or heart attacks. There are three types of permanent pacemakers, and depending on a person's condition, his cardiologist will determine which type is necessary. After a person has one of these devices implanted, there are a few things that should be avoided to ensure that the device does not malfunction.
The pacemaker device that is implanted into the chest is roughly the size of a large coin, but thicker, with one or two wires running it. These wires are called leads, and the electrodes on the ends are responsible for delivering the small electric shocks that stimulate the heart to pump. The case is typically made from a material that will not cause problems in the body, such as the immune system trying to reject it. Modern pacemakers are often made out of titanium.
Inside the airtight case of a permanent pacemaker, there is an energy source to keep it going. When they first introduced, some of these devices were plugged into the wall to recharge. As time went on, however, smaller, safer, and more efficient pacemaker batteries were used. A lithium battery is often used in most permanent pacemakers. Also inside is a sensor that monitors the patient's heartbeat and a device that produces the small electric impulses.
Permanent pacemaker insertion involves making a small cut on the patient's upper chest, usually just under the collarbone. A pocket is made beneath the skin and fat for the pacemaker. To implant the leads and electrodes, surgeons must locate a major vein, typically the subclavian vein. This vein is then pierced, and using a tiny camera, the leads are guided through it, into the heart.
The end of each lead is implanted into one of the chambers of the heart, and the other end is connected to the permanent pacemaker device. This device is then tested by the cardiologist to ensure that it is working properly. The pacemaker is tucked into the pocket made in the chest, and everything is stitched up. Generally, this procedure does not take more than an hour or two.
A single-chamber pacemaker has only one lead, which is inserted into only one of the chambers of the heart. A dual-chamber pacemaker is a bit more expensive, but it is thought to mimic a natural heartbeat more effectively. These pacemakers have two leads, each of which is placed in a different chamber of the heart. Another type of pacemaker is a rate responsive pacemaker. This device is able to adjust a patient's heartbeat in relation to the amount of physical activity that is being done at that moment.
For a few months after surgery, a patient is often advised against using his arm or shoulder too much, or partaking in vigorous activity. After this, he will often be advised by his cardiologist to stay away from high voltage areas, strong magnetic fields, and radiation, as any of these can possibly cause the permanent pacemaker to malfunction. Cellular phones are considered safe, as long as they are kept away from the area that the pacemaker was implanted.
When a pacemaker malfunctions, a patient may feel a change in his heart rhythm or dizziness. If any of these symptoms occur, he should move several feet back and check his pulse. If it does not go back to normal within a few minutes, emergency medical treatment may be necessary.
