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Pacemakers
What is a pacemaker?
A pacemaker is a device that can deliver a small electrical impulse to the heart muscle to stimulate it and make the heart beat. It is usually a small box placed under the skin, frequently in the left side of the chest. Connected are small leads that we insert through the veins to the bottom chamber of the heart (the ventricle). We often place a second lead into the top chamber of the heart (the atrium).
Why do I need a pacemaker?
The heart has its own system of making your heart contract and beat, known as the conducting system. Small electrical currents pass through the tissue of the heart. Sometimes, this system doesn’t work the way it should, meaning the top chambers of the heart (the atria) don’t communicate with the bottom chambers (the ventricles).
When this happens, the heart beats slower than usual. You may feel faint or light-headed. Sometimes, you may pass out. In rare cases, the heart may stop beating.
With a pacemaker in place, if the heart beats too slowly, the pacemaker would take over and ensure that the heart beats at a normal rate. A pacemaker can significantly improve your quality of life and, in some cases, be life-saving. We will discuss the different types of pacemakers with you and decide which is suitable for you together.
What causes my heart to beat slowly?
The most common reason for pacemaker insertion is that the heart’s conducting system wears out and stops working effectively due to age. Sometimes, other diseases and conditions can affect how well the heart beats, such as the derangement of salts in the blood.
If your heart beats too fast and needs medication to slow it down, we may recommend having a pacemaker to regulate this
How is a pacemaker inserted?
We usually perform this as a day-case procedure using sedation (medication to make you sleepy) and local anaesthetic (medication injected under the skin to numb it). We cut the skin in the upper chest (usually the left side), so we can form a pocket under the skin to fit the generator or battery of the pacemaker.
What are the risks of the procedure?
Pacemaker implantation is usually very straightforward. Complications occur in 1-2% of cases.
The main risks from the procedure include:
- Infection
- Bleeding and bruising
- Scratching the surface of the lung (pneumothorax)
- Bleeding around the heart
- Movement of the leads
Almost all the complications are treated at the same time.
How long will it take to recover after pacemaker insertion?
The only wound that needs to heal is the cut. There may be some bruising around it. Depending on the type of sutures (stitches) we use, these may need to be removed in 7-10 days. The hospital staff will be able to tell you if and when you need to get them removed.
Do not raise your left arm above the shoulder for six weeks after the pacemaker insertion, as it takes six weeks for the pacemaker lead to bed in and fix in place.
If you move your arm, the lead may dislodge and move. Then the pacemaker will not be able to function normally, and you may need another procedure.
Can I drive after the procedure?
You cannot drive for a short time following the pacemaker implant and will need to inform the DVLA. The length of time you cannot drive depends on the reason for implanting the pacemaker. Your cardiologist will be able to advise you further.
What will the follow-up be?
We usually check the pacemaker around one month after insertion to ensure it is working satisfactorily and there are no problems. After that, we’ll likely check it every six months to a year.
After we insert the pacemaker, you receive a pacemaker identity card that will say which type of pacemaker you have and the insertion date. Carry this with you at all times. It will include a contact number for who you should call if there are any problems.
How long will the pacemaker last?
The pacemaker battery (or generator) will last around 7-10 years. After this time, it will need replacing. It is a very similar procedure to the original insertion. Though we only replace the battery attached to the existing leads. The leads can stay in as long as they’re working effectively. These leads usually never need replacing and last the rest of your life.
Book an appointment
Breathlessness can feel uncomfortable and unsettling, but we’re here to help put you at ease.
Our specialist will discuss your treatment in depth so you understand its purpose and how it will work. We are happy to answer any questions to ensure you feel comfortable with our treatment plan.
Call London Heart Clinic on 0203 303 0325 to book an appointment.
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After suffering from a heart condition for a number of years I was very happy to meet Dr Ahsan, from the first consultation where he believed there was a solution I have now completed the surgery and had my final consultation with him today…
I am very grateful to have Dr Syed Ahsan as my consultant. Dr Ahsan always greets you warmly on each visit despite his busy workload. Dr Ahsan explains everything clearly and helps you to understand even the most complex medical terms…