A pacemaker is associated with people with a heart condition, but not many people are aware of what the device is all about and why is it implanted. Also, people who already have a pacemaker have many queries like how often does one need to replace a pacemaker, or how to choose the best pacemaker within their budget. Well, all your queries on a pacemaker are answered by our expert Dr Santosh Kumar Dora, Consultant cardiology and electrophysiology, Asian Heart Institute, Mumbai.
1. What is a pacemaker?
An electrical device, apacemaker helps in maintaining the heartbeat of a person with slow heart rate. It is a tiny device which weighs around 25 - 35 gms. The device works by sending an electrical impulse to heart muscles, which induces an artificial heartbeat in patients suffering from a slow heart rate.
2. When do you need to implant a pacemaker?
The normal heart rate is 60 - 100 per minute and when it drops, it is a cause of concern. So after a series of tests, your doctor will decide whether you need a pacemaker or not. However, there are certain symptoms that indicate your heart rate has fallen below the normal range. These include giddiness, black out episodes or experiencing unconsciousness. If you have any such symptoms, then consult your doctor as it might be necessary to implant a pacemaker. Read more about do you need this pocket-sized device to monitor your pacemaker at home?
3. How does a pacemaker work?
A pacemaker not only stimulates the heart muscles but can also sense the heart rate. So if your heart rate falls, it stimulates the heart muscle to increase the heart rate and if the heart beats normally, then it does not stimulate the heart. In simple words, a pacemaker works on the principle of demand pacing, which not only saves the battery but also makes it last longer.
4. Where is a pacemaker implanted?
A pacemaker is implanted under the skin and fat tissue, just below the collar bone (either on the left or the right side of the body). While one of the lead is passed through the vein and connected to the heart muscle, the other end is attached to the pacemaker. The parameters of the pacemaker can be changed externally with the help of a programmer.
5. Do I need to use a pacemaker for the rest of my life if I am using one?
Yes, you have to use a pacemaker lifelong if implanted once. A pacemaker is implanted when your doctor feels the heart needs it to function properly. Usually, a pacemaker lasts for 8 to 12 years, depending on the current it spends for the heart to beat regularly.
6. How do I know that the pacemaker has to be replaced?
The pacemaker runs on battery, which normally lasts from 8 to 12 years. On routine follow up, your doctor will tell you how much battery life is remaining. Before the battery gets fully depleted or is nearing depletion, the pacemaker needs to be replaced. Also, read about could your pacemaker be malfunctioning?
7. How to choose a pacemaker?
Your doctor will select the pacemaker best suited for you based on your condition. The dual chamber pacemakers are the most commonly used as they make the cardiac function as normal as possible. However in certain conditions, like atrial fibrillation with slow ventricular rate, your doctor may prefer a single chamber pacemaker. Currently, MRI compatible pacemakers are preferable as it allows MRI investigation if needed in the future.
8. Do I need to stay away from electronic devices if I have a pacemaker?
It is the most common query as the patient often likes to know how the pacemaker affects his lifestyle. Although the use of electronic devices is permitted for a person with a pacemaker, you need to keep few tips in the mind. The handheld devices like mobiles should be kept at least 15 cm away from the pacemaker device. You can operate a computer, watch TV, operate a microwave oven, etc. However, stay away from the security devices being used for metal detection. If need, ask the security person to check manually and request not to put the handheld metal detector directly over the pacemaker. Here's more on why you need to keep your smartphone away if you wear a pacemaker.
9. What about diagnostic tests like X-ray and MRI scan?
Most of the diagnostic tests like X-ray, an ultrasound test, echocardiogram, CT scan can be performed on patients with pacemaker. However, MRI cannot be performed on patients with a pacemaker which are not MRI compatible. Hence, while opting a pacemaker ensure that the device is MRI compatible, which is widely available.
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