Pacemaker : Surgery, Types And What it is?

A heart is an organ of muscle tissues stimulated by electrical currents following a particular circuit within the heart. The process of electrical stimulation followed by the heart's muscle contraction makes a heartbeat. 

What is a pacemaker?

A pacemaker is a device that helps regulate the heart's electrical circuit and maintain the heartbeat when it slows down. The device's structure is divided into a pulse generator, multiple leads, and an electrode on each lead. In slow or irregular heartbeats, the device signals the heart to beat in a particular rhythm. The device recognises the heart's slowed beats and sends an electrical signal through the device to keep the heart rate at a regular pace. 

After pacemaker surgery, patients are required to undergo timely medical checkups. These checkups help monitor the device's functioning and adaptability to the patient's heart. 

What is a pacemaker surgery? 

The procedure of pacemaker implantation is known as a pacemaker surgery:

Mentioned below are the steps followed to perform a pacemaker surgery:

• The surgery involves emptying the bladder before the procedure. 
• The incision site is cleared off from any hair over it.  
• An IV line is introduced through the hand or arms to insert vital medication before the procedure.
• The patient is connected to the ECG machine, which monitors the patient's heartbeat, breathing rate, oxygen levels, and other vitals. 
• Electrode pads are placed on the chest and the back of the patient.
• A sedation medicine is given to the patient to allow one to stay calm as well as awake during the procedure. 
• The site of insertion is cleansed with soap.
• A local anaesthesia is inserted at the site of insertion. 
• The procedure begins with a physician making a small incision at the surgical site.
• A plastic tube is introduced into the blood vessel to insert the pacemaker's lead wire, which is further advanced to the heart. 
• After a lead wire is inserted into the heart, it is tested to determine its proper location and functioning. 
• After attaching the lead wire to the pacemaker generator, an incision near the collarbone slips the generator under the skin. 
• The ECG helps to monitor the proper functioning of the inserted device.

Types of Pacemaker 

Different types of pacemakers are advised for patients depending upon the patient's health condition. Mentioned below are some of the usually opted pacemakers by doctors: 

• Leadless Pacemaker -It is a small electrical device attached to the walls of the heart in case of slowed heartbeats. As the name states, ''Leadless,'' the device doesn't have any leads and is a one-piece device attached to the heart. The device doesn't need a separate battery or any lead wires, as the whole device sits in the right chamber of the patient's heart. The device is around 3 to 4 centimetres and shaped like a cylinder.
• Single Chamber Pacemaker - A single-chamber pacemaker has one lead connected to the pulse generator, further connecting one heart chamber. The device helps to regulate slowed heartbeats. The device's lead is connected to the right ventricle. Depending on the patient's condition, the lead is also connected to the right atrium to maintain the pace of the chamber. 
• Dual Chamber Pacemaker -The device comes with two leads to connect with the heart's right side chambers, namely the right atrium and the right ventricle. The doctor programs the device to regulate the contractions of these chambers. The device ensures that the right chambers maintain a proper rhythm by contracting and relaxing accurately. It provides the appropriate flow of blood in the heart. Hence, depending on the symptoms and heart conditions, a doctor may suggest a dual-chamber pacemaker to the patient. 
• Biventricular Pacemaker - The device is highly used for patients with severe symptoms of heart failure arrhythmia. It is also known as a cardiac resynchronisation therapy (CRT) device. The three leads of the device are connected to both the ventricles and the right atrium. The device is programmed to coordinate the contractions of the ventricles to ensure they pump together. 

Conclusion 

A pacemaker is a device suggested to a patient in case of slowed or irregular heartbeats. The device is inserted during a surgical procedure. Depending on their various heart issues, Different pacemakers are suggested to patients. 

Frequently Asked Questions 

Q1. What is a pacemaker?
A1. An electrical device placed on the heart's walls to regulate the heartbeats is known as a pacemaker. 

Q2. What are the health symptoms indicating the use of a pacemaker?
A2. Chest pain, irregular heartbeat, heart palpitations, shortness of breath, and frequent swelling of ankles and feet are some of the signs indicating the use of a pacemaker for a patient.  

Q3. How does a pacemaker help a patient with heart issues?
A3. A pacemaker helps regulate heartbeats and lower different types of heart issues, making a patient feel calm and perform various regular activities with ease. 

Q4. What are the different types of pacemakers?
A4. Some of the different types of pacemakers are leadless, single-chamber, dual-chamber, and biventricular. 

Q5. What are the possible complications faced after the insertion of a pacemaker?
A5. Blood clots, improper functioning of the device, allergic reactions, and unexpected heart rhythm problems are some of the possible complications faced by the insertion of a pacemaker. 

Reference Links:

• https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pacemaker-insertion
• https://my.clevelandclinic.org/health/treatments/17360-permanent-pacemaker
• https://stanfordhealthcare.org/medical-treatments/p/pacemaker/types.html