Pacemakers: What They Do and When They Are Needed
A pacemaker is a small device implanted under the skin that monitors the heart's rhythm and delivers gentle electrical impulses when the heart beats too slowly or irregularly. For people whose heart rhythm cannot reliably sustain adequate circulation, it can restore normal daily function.
When a pacemaker is considered
Pacemakers are most commonly used when the heart beats too slowly (bradycardia) or when the electrical signal between the upper and lower chambers is delayed or blocked (heart block).
Symptoms that may prompt assessment include fainting or near-fainting, persistent dizziness, unusual fatigue, and breathlessness on mild exertion. Diagnosis usually involves an ECG and often longer-term rhythm monitoring.
What implantation involves
The procedure is usually performed under local anaesthetic with sedation. A small incision is made below the collarbone, one or more thin leads are guided through a vein into the heart, and the device is placed in a pocket under the skin.
It commonly takes one to two hours. Most people stay in hospital briefly afterwards for observation and device checks.
Types of device
Single-chamber and dual-chamber pacemakers differ in how many leads are used and which chambers are paced. Biventricular devices, used in cardiac resynchronisation therapy, help the chambers of a weakened heart contract in a more coordinated way.
An implantable cardioverter-defibrillator (ICD) serves a different purpose — it can deliver a shock to correct a dangerous fast rhythm. Some devices combine functions.
Living with a pacemaker
Most people return to normal activities, including work, driving and exercise, guided by their cardiologist. Arm movement on the implant side is usually restricted for a short period initially.
Modern devices are well shielded. Household appliances and mobile phones are generally not a concern, though phones are usually kept on the opposite side. Airport security should be informed, and you should carry your device identification card. Certain medical procedures, particularly MRI, require the device to be checked for compatibility beforehand.
Devices are checked periodically, and batteries typically last several years before the generator is replaced in a smaller procedure.
Frequently asked questions
How long does a pacemaker battery last?
Typically several years, varying with device type and how much pacing is required. Regular checks track battery status well in advance of replacement.
Can I use a mobile phone with a pacemaker?
Yes. It is generally advised to hold the phone to the ear opposite the device and avoid carrying it in a pocket directly over it.
Will I feel the pacemaker working?
Most people do not. Some notice a sensation initially that settles as they adjust.
Can I have an MRI scan?
Many modern devices are MRI-conditional, meaning scans can be performed under specific conditions. Always inform the radiology team about your device beforehand.
Have a question about your heart health?
Consultations with Dr. Ray are held at Fortis Hospital, Anandapur, Kolkata.
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