A pacemaker is a certain type of device which is intended tosend electrical pulses to the heart muscles so that a normal heart rate can bemaintained. A pacemaker is also very efficient in stimulating the ventricles. Forthose who do not know, ventricles are the lower chambers of the heart. In somecases, pacemaker may be used for the treatment of several different types ofmedical conditions such as hypertrophic cardiomyopathy, congestive heartfailure and fainting spells. There are different types of pacemakers which areused for different types of heart conditions and can be characterized bydifferent minimum heart rates to which they need to be set. Once the heartrates below the certain minimum rate, the pacemaker generates the artificialimpulse, contracts the heart muscles and thus creates a heartbeat.
Electrical System of the Heart
The electrical system of the heart is actually the powersource which makes the alternate contraction and relaxation of the atria andventricles, which work together so that the blood could be pumped through theheart. The sinoatrial node is located in the right atrium of the heart and itis the source of all electrical impulses, from which they all spread outthrough the walls of the atria so that they can contract properly. The electricalimpulses then travel through the AV node which is located between theventricles and the atria. This node is in charge of slowing the electricalsignals before they get to the ventricles. The next stage of the travels of theelectrical impulses is the His-Purkinje network which consists of a pathway offibers especially efficient in conducting electricity. From here the impulses travel further to themuscular wall of the ventricles. A pacemaker is required in all situations inwhich the electrical pathway does not function the way it is supposed to andwhen certain changes in the heart rhythm and rate occur.
Pacemaker Procedure and its Risks
Pacemaker implant is an invasive type of surgical procedure,so like any other, it is involved in certain risks, but in most cases it is acompletely safe procedure due to certain precautions taken so that the riskscan be reduced. Persons who are about to undergo a pacemaker implant usuallyneed to stop taking warfarin and Aspirin a few days before the actualprocedure. Certain other types of medications may also need to be stopped priorto the surgery. These matters are commonly discussed with the doctor. Those whosuffer from diabetes may need to readjust the dosage of insulin and diabetesmedications. The patient is not allowed to eat or ingest any fluids beforegoing to bed prior to the surgery. All nail polish and makeup need to beremoved, and the person is supposed to wear a hospital gown during theprocedure. All valuables, watches and jewelry must not be worn during theprocedure. The procedure is commonly performed in the pacemaker lab. The nursefirst starts an intravenous line, which is there to provide the fluids and themedications during the procedure. This includes the antibiotics. The chestneeds to be shaved and cleansed with a special soap. The procedure does notinvolve putting the patient to sleep, but certain medications are used to makehim or her feel drowsy. During the procedure, the patient is constantlymonitored. The monitors used during the procedure include fluoroscopy, which isa big X-ray machine, oximeter monitor which check the level of oxygen in theblood, blood pressure monitor, electrocardiogram which checks the electricalimpulses in the heart and the defibrillator which regulates the heart rate. Asalready explained, a pacemaker implant may be associated with certain risks,like any other surgical procedure. One of the possible risks is a perforationin the muscle layer of the heart which may trigger an unwanted fluid builduparound the heart. Another possible risk during a pacemaker implant is an airleak around the lungs. One may also experience certain problems with the pacingleads, which usually occur when one of the leads moves out of its normalposition. The most common types of risks which may be associated with thepacemaker implant are various sorts of infections.
After the Procedure
Once the procedure is done, the person needs to stay at thehospital for two days. Once the doctors determine that the implantation wassuccessful, the patient is free to go home. During the hospital stay, thepatient is constantly monitored by a device called the telemetry monitor.Another type of monitor which is attached to the patient by sticky electrodepatches is called the holter monitor. There are certain tests which need to beperformed following the procedure. Those tests include an X-ray scan of thechest. The patient may feel slight discomfort for 2-3 days after the procedure.