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Heart pacemaker

A pacemaker is a small electrical device that's implanted in the chest to help the heart beat regularly for people with some heart problems.

Pacemaker implantation is a common procedure with around 40,000 operations carried out in England each year.

The pacemaker has two parts: the leads and a pulse generator. The pulse generator houses the battery and a tiny computer. The leads are wires that are threaded through the veins into the heart and implanted into the heart muscle. They send impulses from the pulse generator to the heart muscle, as well as sense the heart's electrical activity.

Each impulse causes the heart to contract. The pacemaker may have one to three leads, depending on the type of pacemaker:

  • Single-chamber pacemakers use one lead in the upper chambers (atria) or lower chambers (ventricles) of the heart
  • Dual-chamber pacemakers use one lead in the atria and one lead in the ventricles of your heart
  • Biventricular pacemakers use three leads: one placed in the right atrium, one in the right ventricle, and one in the left ventricle (via the coronary sinus vein)

Your doctor will decide what type of pacemaker based on your heart condition and programme it for a minimum heart rate. When your heart rate drops below that set rate, the pacemaker generates an electrical impulse that passes through the lead to the heart muscle. This causes the heart muscle to contract, creating a heartbeat.

Pacemakers are also used to treat the following:

  • Bradyarrhythmias, which are slow heart rhythms that may arise from disease in the heart's electrical conduction system (such as the SA node, AV node or HIS-Purkinje system)
  • Heart failure. This device is called cardiac resynchronisation therapy (CRT) or biventricular pacing
  • Hypertrophic cardiomyopathy
  • Syncope ( fainting spells)

What should I do before getting a pacemaker?

Your doctor may ask you to stop taking certain medications one to five days before the procedure. If you have diabetes, ask how you should adjust your diabetes medications.

  • Do not eat or drink anything after midnight the evening before the procedure. If you must take medications, take them only with a sip of water
  • When you come to the hospital, you will change into a hospital gown for the procedure. Leave all jewellery and valuables at home

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