What is a pacemaker?
The pacemaker is a small device that helps a diseased heart to beat in time again. It is inserted below the collarbone just under the skin or the chest muscle. Pacemakers are equipped with long wires (electrodes/probes) that reach into the heart via a large vein. There they measure the activity of the heart muscle.
This is because the device (pacemaker unit with battery and pulse generator) detects the heart’s action. If the heart itself beats sufficiently fast, continuous pulse delivery is suppressed. If necessary – if the heart beats too slowly – the pacemaker stimulates the heart. To do this, the device transmits an electrical impulse via the electrodes to the heart muscle, which then contracts (contracts).
What a pacemaker looks like depends on the model and manufacturer. But it usually resembles a somewhat larger and bulky two-euro piece, from which two tubes lead. These are the electrodes that the surgeon puts in the right place in the heart.
Pacemaker surgery
The electrodes are then checked to ensure that they measure the heart’s own electrical activity correctly and that the impulses emitted by the pacemaker are received correctly. If everything is working properly, the skin over the pacemaker is closed again.
A pacemaker operation is still possible at an advanced age, if the physical resilience allows it. If the affected persons are physically able to cope with an operation, then there is no age limit for a pacemaker implantation.
Risks of pacemaker surgery
The pacemaker surgery is not associated with any major risk. However, as with any surgery, complications can still occur. These include, for example:
- Wound inflammation
- @ Bleeding
- Muscle twitching
- Damage to nerves or soft tissues
- Air embolisms
The treating medical team naturally takes precautions against these complications. All patients are also given extensive information before the operation and have the opportunity to ask questions about the implantation and life with a pacemaker.
Pacemaker: Risks and side effects
Side effects of the operation
Implantation of the pacemaker leaves a small wound. Therefore, you may experience pain after the pacemaker is implanted. However, the pain is not caused by the device itself, but by the wound that is made during the surgery. This wound pain subsides once everything has healed after the operation.
Side effects of the operation
Implantation of the pacemaker leaves a small wound. Therefore, you may experience pain after the pacemaker is implanted. However, the pain is not caused by the device itself, but by the wound that is made during the surgery. This wound pain subsides once everything has healed after the operation.
If patients suddenly have hiccups after pacemaker surgery, this indicates unwanted electrical excitation of the diaphragm. Tingling in the arm can also be a sign that a probe has been misplaced. Normally, surgery must then be performed again to position the wires correctly.
Pacemaker syndrome can occur with a special type of pacemaker (VVI pacemaker). It is manifested by low blood pressure, shortness of breath, dizziness and fainting spells.
What has to be considered after a pacemaker implantation?
As a rule, patients experience life with a pacemaker as completely normal. In most cases, they are much more efficient and resilient than before because their heart now functions much better. Directly after pacemaker surgery and later in everyday life, however, there are a few things you should keep in mind.
Behavior directly after pacemaker surgery
In the first few days after pacemaker surgery, you should initially hold back on strenuous physical activities. On the one hand, the body still has to recover after the operation, and on the other hand, it takes a few weeks until the device and the wires are really firmly in place. In principle, however, you can do everything that is good for you.
Following the operation, you will be issued with a pacemaker identification card, which you must always carry with you. How often you need to have a pacemaker check-up depends on your underlying disease and the device used. You can arrange the check-up appointments individually with your cardiac specialist.
Behavior in everyday life
Dealing with electrical devices: The electromagnetic fields emitted by electrical devices can interfere with the work of the pacemaker. Especially devices that contain strong magnets can cause problems. This also includes induction stoves in the kitchen which work with magnets. Read the corresponding notes in the operating instructions.
Alcohol: The consumption of alcohol is not prohibited. In most cases, however, the reason for implanting a pacemaker is a cardiac arrhythmia. Alcohol exacerbates heart problems, so people with implanted pacemakers are advised not to drink alcohol. Seek open discussion with your health care provider regarding alcohol use after pacemaker surgery. This will allow them to better assess your individual risks and advise you.
Flying with a pacemaker: Depending on the model of the pacemaker, it is no problem to fly with the aircraft. However, especially the older devices are susceptible to electromagnetic fields that cause interference. In this case, flying is very dangerous. To find out whether your device is suitable for air travel, it is worth taking a look at the instructions for use or talking to your doctor and the airline.
Cardiac pacemaker: life expectancy
When is a pacemaker necessary?
According to the German Pacemaker Registry, physicians implanted approximately 73,101 new pacemakers in Germany in 2020. The reasons were mostly:
- Cardiac arrhythmias in which the heart beats too slowly (bradycardia): AV block, sick sinus syndrome or thigh block.
- @ Atrial fibrillation (bradyarrhythmic atrial fibrillation)
A rarer pacemaker indication is a heart attack, if this has damaged conduction cells of the heart. A pacemaker is also sometimes necessary after bypass surgery or ablation of the heart. Sometimes a pacemaker is only used temporarily, for example in the case of an overdose of the heart drug digitalis.
Cardiac pacemaker: Types
Which pacemaker is implanted depends on the type of underlying condition. For example, if the sinus node – the heart’s clock generator – is not working properly, single-chamber pacemakers are implanted. In these types, the probe extends into the right ventricle and delivers a pulse whenever the heart’s own excitation is absent. The impulse from the probe then triggers a heartbeat that propagates in reverse toward the atria, so to speak.
If the heart’s cable system (the line from the sinus node to the heart muscles) is affected by a malfunction, pacemakers with two electrodes are inserted – one in the right atrium and one in the right ventricle.
If it is found over time that the type of arrhythmia has changed, the function of the implanted pacemaker can also be adjusted.
