Do I Need a Pacemaker?
The Basics of Heartbeat Health, Pacemaker History, and Surgery Risks
Do you have an irregular heartbeat? Does the doctor recommend a pacemaker? Here are the basics. You'll be glad to know it's not your grandfather's pacemaker anymore.
What is a Healthy Heartbeat?
A healthy heartbeat is the rhythm of life. But what is a healthy rate? In adults, the heart beats 60 to 100 times a minute. Your level of fitness, as well as medications, stress, a blood clot, heart disease, and any of several other conditions may contribute to variations in this healthy rate.
What are the Symptoms of an Unhealthy Heartbeat?
If you are experiencing anything other than a regular, healthy heartbeat you may be a candidate for a pacemaker. Symptoms of an irregular heartbeat include fatigue, shortness of breath, and dizziness. The most common name for the condition of experiencing a slow or irregular heartbeat is bradycardia. Atrial fibrillation is also a common condition where the upper chambers of the heart beat irregularly. Heart failure results when the heartbeat cannot meet your normal blood and oxygen needs.
What Will a Doctor Do?
A doctor will run an EKG or electrocardiogram to produce a strip of paper that graphs your heartbeat. If it is slow or irregular, he will run a battery of tests to make certain that a pacemaker will help you. For example, if an underactive thyroid gland is the problem, medication will help. If you are anemic, supplements of iron may be prescribed.
The Pacemaker
If no other underlying cause can be found, a pacemaker may be for you. Pacemakers detect the heart rate and send electrical impulses to the heart. The pacemaker becomes a part of the body’s pacing or electrical system. About 100,000 of these small battery operated units are implanted in the United States every year. Today’s pacemakers take over the role of the heart when a small lead that extends from the pacemaker device to the heart detects that it is needed.
Pacemakers have come a long way! The first pacemakers were powered by electricity from a wall socket, so the person who wore one was limited in his travels by the length of his extension cord. The first battery powered pacemaker was developed in 1957 and the first implanted pacemaker followed in 1960. These required that leads be attached to the outside of the heart, which meant major surgery to open the chest cavity. Later generations of the pacemaker incorporated leads that were fed through a vein to the heart, eliminating the need for extensive surgery and general anesthesia. On-demand pacemakers came about in the mid 1960s. They detected the heartbeat and provided electrical impulses only when needed. In the next decade, pacemaker leads and cases were improved. Titanium cases allowed wearers to be less concerned about electromagnetic interference from microwave ovens and other such devices.
Pacemakers have become increasingly more sophisticated, can perform more functions, and are much smaller. Today’s pacemaker is not your grandfather’s pacemaker.
Implanting the Pacemaker
Today, surgery to implant a pacemaker can be done using a local anesthetic. A tiny incision is made to access the vein and place the device. The operation takes approximately an hour.
There have been few complications, which usually include bleeding at the incision, developing a blot clot where the lead enters the vein, and bruising. If the lead becomes dislodged, a patient will have to go back into surgery since the incision would need to be reopened.
The Future of Pacemakers
The next decade may bring many exciting changes. Researchers in Israel as well as from Johns Hopkins and UC Davis have found that genetically engineered heart cells from human embryonic stem cells hold promise as an alternative to the electronic pacemaker.
