CARDIAC

PACEMAKER
BY E.Deepika
 What is a pacemaker?
A pacemaker is a small unit that helps your heart beat
more regularly

A pacemaker uses batteries to send electric signals to

your heart to help it work in the right way

The pacemaker is placed under the skin of chest ,just

under the collarbone

It's hooked up to heart with tiny wires

 Who need it?
The most common reasons are :
Bradycardia
 heart block

Bradycardia: The heartbeat that is very slow is called

Bradycardia.

Heart Block: Heart Block is a problem with the heart’s

electrical systems. The disorder Occurs when an electrical
signal is slowed or disrupted as it moves through the heart.
 The Heart’s Electrical System
It controls the rate and rhythm of heartbeat
With each heartbeat an electrical signal travels from top
of the heart to the bottom
Each electrical signal begins in a group of cells called SA node
From SA node it travels through special pathways in the right and left
artia
The signal then moves down to a group of cells called AV node
After this the signal leaves AV node and enter pathway called
Bundle Of His
This pathway divides into a rbb and a lbb
 The signal goes down these branches to the ventricles, causing them
to contract and pump blood out to the lungs and the rest of the body.
The ventricles then relax, and the heartbeat process starts all over
again .
Attach the pacemaker system

Pulse generator
Sensing and pacing leads

Make it into a circuit

Put the system into the body /under the skin and join to the
heart by pacing wire

Program its function by the programmer

 Pulse generator

Sensing and pacing leads

How does a pacemaker work?
A pacemaker consists of

Battery
Computerized
generator
Wire with sensors
called electrodes on one
end
•The battery powers the generator. The battery in a
temporary pacing box is a regular hardware-store type 9-volt
battery.

•The wires connects the generator to the heart

•The electrodes detect the hearts electrical activity and send

data through the wires to the computerized generator

•If the heart rhythm is found to be abnormal, the

computerized generator sends Electrical pulses to your
heart.

•The pulses then travel through the wires to reach your

heart
Pacemakers circuit
 Types of pacemakers
The pacemaker have one to three wires
that are placed in different chambers
of heart

•The wire in a single chamber

pacemaker carry pulses between the
right ventricle & generator
•The wire in dual chamber pacemaker
carry pulses between the right atrium
& the right ventricle & the generator
•The wire in biventricular pacemaker
carry pulses between an atrium & both
ventricles & the generator.
this is also called as cardiac
resynchronization therapy (CRT) device
Biventricular pacemaker
Single wire pacing
•Example:

One spike
implies single
wire pacing

Dual wire pacing

•Example:

Two spikes
indicated by the
arrows
Types of pacemaker programming
Demand pacing
Rate responsive pacing

Demand pacing: It monitors the heart rhythm. It only sends

electrical pulses to your heart if
your heart is beating too slow or if it misses a beat

Rate responsive pacing: It will speed up or slow down the heart

rate depending on who active
the heart is. To know how active the heart is this pacemaker
monitors the SA node rate,
Breathing, blood temperature etc

Generally rate responsive pacemakers are preferred.

 Use of magnets
After the surgery being done the physicians places a
ring-shaped magnet on the patients’ chest over the
pacemaker. The idea here is that there is a switch inside
the pacemaker with a ferrous reed, which is pulled from
one position to the other by the magnet. This is involved
in figuring out how much longer the pacers’ battery has
to live, and also changes the pacemaker into
asynchronous modes for testing purposes.
 precautions
•Pacemakers may not function correctly in power generating
machinery, arc welding equipment or powerful magnets like
work settings.try to avoid such places.
•During airport security: The pacemaker is made of metal, it
can trigger the airport metal detector, so inform the security
check authorities before entering the metal detector
•When having a medical procedure, alert the health care
professional. while X-rays will not impact a pacemaker.
Therapeutic radiation can cause havoc with the circuit inside
pacemaker
•Carry pacemaker card at all the times
THANK
YOU