Pacemaker

General Information

Arrhythmias are abnormalities in the rate, rhythm, or both of the heartbeat. These abnormalities occur with increasing frequency as one ages. Under normal circumstances, the heartbeat is regular in its timing, and the heart rate falls into somewhat narrow limits of numbers of heartbeats per minute. The heart rate increases with exercise.

Some arrhythmias pose no threat to your health. Others have great implications for the development of more serious problems. Careful evaluation to figure out the cause of the arrhythmia also allows your physician to determine the significance of the arrhythmia.

Many arrhythmias are treatable with medication. The best treatment for some is substituting an electronic pacemaker for the heart’s own pacemaker.

Important Points in Treatment
Treatment with an electronic pacemaker (a device used to regulate the heart rate and rhythm) is used to alter the heart rate and rhythm and keep the heart rate close to normal. If this therapy is done for a very short time in the hospital, a pacemaker device outside the body is connected by wires to the heart muscle. This is a temporary pacemaker. If longer term treatment is necessary, a tiny battery-powered pacemaker may be placed under the skin by a surgeon. These are implanted pacemakers.

Implanting a pacemaker is not a major operation. Some restrictions on activity are necessary for 4 to 6 weeks after pacemaker insertion. Until the healing of the incision and healing around the wires to the heart is complete, you should not do heavy lifting, arm exercises, or stretching with the arm on the pacemaker side of the body. Often a loose sling is worn as a reminder. This arm should be kept active, but without strain. Controlled activity is important to prevent the joints from stiffening and the arm from becoming weak. Often you must learn to slip loose clothes, such as a sweatshirt, over the pacemaker-side arm and shoulder first when dressing.

Pacemakers require regular checkups and service. With regular maintenance, they can last for 10 years or more before replacement. Pacemaker checkups require only a brief visit to the physician. Sometimes physicians have equipment that allows these checkups to be done over the telephone. Besides these checkups by your physician, it is important and prudent to monitor the pacemaker function yourself on a daily basis. The pacemaker keeps your pulse at a set rate. Some pacemakers increase the rate automatically when you exercise, but at rest they return to the set rate. If you take your pulse rate each day at rest and approximately at the same time, you should have the same heart rate. If this rate varies or there is any irregularity of the rhythm, you must notify your physician.

Carry a pacemaker identification card so that in case of an accident or serious illness those attending you are aware of the existence of your pacemaker. Pacemakers are well shielded from electrical interference from the outside, but electrical currents and microwaves can affect them.

Occasionally a patient will feel fatigue or dizziness. Fainting may occur. It is also possible to experience a feeling of pulsation in the neck or in the chest. If this occurs, it is a sign that the pacemaker needs adjustment.

Notify Our Office If ...

• You have a frequent or persistent change in your heart rate or heartbeat rhythm.
• You have any sign of inflammation, heat, tenderness, or swelling around the pacemaker.
• You experience unexplained fatigue, dizziness, or fainting; or if there is a sensation of pulsation in your neck or chest.