The heart has a natural pacemaker, but when it fails to work, a mechanical pacemaker might be the best answer. Monitoring the heart’s rhythms, it senses and/or stimulates the heart’s atrial and ventricular chambers with an electrical impulse to restore normal heartbeat. Today’s pacemakers are externally programmable, allowing for a wider choice of pacing modes to best reproduce your natural rhythm.

Arrhythmias, or irregular heart rhythms, may be too fast (tachycardia), too slow (bradycardia), or a combination of these When the heart has difficulty pumping blood, symptoms such as shortness of breath, fatigue or fainting can interrupt your life. In severe cases, these problems can be fatal. To avoid this, pacemakers are often used to restore you to your usual routine.

The implanting physician creates a “pocket” in the subcutaneous tissues of the chest, usually in the left shoulder area, below the collar bone) and inserts the pacemaker (“pulse generator”). Using X-ray guidance, electrodes are threaded up to the heart through a vein. Depending on medical need, one or more electrodes may be used, as one or more chambers may need stimulation (single-chamber or dual-chamber pacemakers). The electrodes are then attached to the pacemaker generator. A rate-responsive pacemaker self-adjusts to accommodate changes in the patient’s physical activities.

Periodic in-office electrocardiography check-ups for pacemakers are routinely done every six months to one year for adjustment or replacement as needed. Normal activities can be resumed after surgery, with some modifications: contact sports are discouraged, as is any work or recreation that might expose you to a high magnetic field (working with MRI, or Magnetic Resonance Imaging Machine, for instance).

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