Pacemaker Implantation and Follow-up

Care
A pacemaker is a device that sends electrical impulses to the heart muscle to maintain
a suitable heart rate or to stimulate the lower chambers of the heart (ventricles).

Our heart has its own internal electrical system that controls the rate and rhythm of our
own heartbeat. With each heartbeat, an electrical signal spreads from the top of your
heart to the bottom. As the signal travels, it causes the heart to contract and pump
blood. Each electrical signal normally begins in a group of cells called the sinus node or
sinoatrial (SA) node. As the signal spreads from the top of the heart to the bottom, it
coordinates the timing of heart cell activity. First, the heart’s two upper chambers, the
atria, contract. This contraction pumps blood into the heart’s two lower chambers, the
ventricles.
As we get older, this electrical system may get worn out. It leads to a condition called a
complete heart block which is diagnosed by a cardiologist looking at the ECG. The
pacemaker would need to be implanted for such patients to keep them going.
Pacemaker insertion is done under local anesthesia. The patient will lie down on the
table under the X-ray camera [ Cath lab]. A small cut is taken under the collar bone
usually on the left side in right-handed people. Wires are passed into the heart
chambers and fixed in the optimal position. An optimal position is judged based on
electrical signals coming from the heart. Then these wires are connected to the
pacemaker box which is implanted in a small pocket under the skin. The wound is
closed and dressed. After a pacemaker insertion, the patient is kept in bed for 12
hours. The patient will have a chest x-ray on the next day and will be discharged home
if stable. The patient is asked to refrain from lifting the left arm above the head for 6
weeks. This helps to prevent the movement of the leads placed in the heart chambers.
The patient can live a normal life. The battery of the pacemaker will last about 10 years.
This can be changed every 10 years on many occasions. Battery life will be monitored
by the yearly checks by the technical team.