A pacemaker consists of a battery which can last around 8-10 years depending on how much the device is used, a pulse generator that generates the electrical impulses to stimulate the heart and leads which carry the electrical impulses to the correct chambers of the heart.
The pacemaker continually senses the heart beat and if it senses that your heart has missed a beat or is beating too slowly, it sends signals at a steady rate to stimulate the heart. If, however the pacemaker senses that the heart is beating normally, it does not need to stimulate the heart. Pacemakers also have a special sensor that recognises body movement or your breathing rate and allows the device to pace the heart faster during periods of increased demand.
Why might I need a Pacemaker?
The most common reason for requiring a pacemaker is a slow heart beat usually heart block which can cause symptoms of dizzy spells, blackouts, tiredness or breathlessness. Pacemakers greatly improve the quality of life of patients that have them implanted. A slow heart beat can arise due to a problem with the heart being able to initiate the heart beat in the first place, or due to a failure of the top chambers of the heart to communicate with the bottom chambers (heart block) or for the electrical impulses generated to fail to conduct and pass along the heart’s own wiring system.
In some patients who have fast and uncontrollable heart beats, a pacemaker may be required in combination with medication. Our experts are highly trained to assess all patients who may need a pacemaker and highly experienced in implanting devices to improve the quality of life of all patients.
The implantation of a pacemaker is a relatively low risk and straightforward procedure. It is the most common type of heart surgery in the UK. The procedure is usually performed under local anaesthetic and conscious sedation.
The pacemaker leads (flexible wires) are advanced to the heart through a large vein under the collarbone and carefully positioned into the correct chambers of the heart with the aid of X-rays and firmly secured into place. The leads are then connected to the pacemaker device which is usually smaller than the size of a small matchbox, and then placed in a small pocket just under the skin.
The wound, which is usually only 5cm long, is carefully sutured and patients can be discharged usually the same day. Pacemakers are checked using programmers which communicate with the devices and allow the doctor and technicians to adjust the device settings to optimise the performance of the pacemaker. Most patients can return to normal activities within 4 weeks of the implant and will require regular ongoing follow up and pacemaker checks to ensure correct functioning of the pacemaker. Although, pacemaker implantation is straightforward there is a low rate of risks related to the procedure including bruising at the site of the wound, infection or movement of the leads after insertion which may require further surgery to reposition and correct this.
Pacemaker procedures tend to have few complications, which you can discuss with your cardiologist in more detail. In general, the following complications are possible:
• Allergic reactions: These may happen because of a medication you’re given or you may be allergic to one of the materials used in the pacemaker itself.
• Blood clots: Your healthcare provider may prescribe blood-thinning medications to reduce the risk of developing a blood clot.
• Malfunctions of the pacemaker or its leads: In some cases, a pacemaker lead may get jostled out of position or might break free. Your healthcare provider will recommend limiting your activity for a while after your procedure to avoid this.
• Malfunctions caused by sources outside of your body: Your healthcare provider will give you instructions on devices or machines to avoid so you don’t have pacemaker problems caused by outside electrical interference. Fortunately, advancements in pacemaker technology mean these situations aren’t common.
• Unexpected heart rhythm problems: Some people develop heart rhythm problems — in rare instances — because of the pacemaker. Your healthcare provider can talk to you about these risks and help you avoid them.
You may feel some pain or discomfort during the first 48 hours after having a pacemaker fitted, and you'll be given pain-relieving medication.
There may also be some bruising where the pacemaker was inserted. This usually passes within a few days. Tell the staff if your symptoms are persistent or severe.
Most people are able to go home on the day they have the procedure or the day after. You'll need to arrange for someone to pick you up from hospital and take you home.
Before going home, you'll be given a pacemaker registration card, which has the details of the make and model of your pacemaker. Always carry the card with you in case of an emergency.
You may also want to wear a MedicAlert bracelet or necklace engraved with important information, such as the type of pacemaker you have, a personal identity number and a 24-hour emergency phone number.
Find out more about medical ID jewellery on the MedicAlert website
While it depends on the specific model of pacemaker and how often it has to assist your heart, pacemakers are now available that can last as long as 10 or 15 years. We can tell you the average lifespan of the device you’ll receive, and will also schedule follow-up appointments to check your pacemaker’s battery level. It’s also usually a simpler process to replace a pacemaker battery than it was to implant the device in the first place.