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Heartline Magazine July - September 2004
Living with Your Pacemaker
Now that you have a pacemaker (or soon may get one), you may
be wondering why you need one and how a pacemaker works. Your artificial
pacemaker is a modern marvel; it's medical science's solution to the electrical
problems of a slow or irregular heartbeat. But before you can understand how
your pacemaker works, you first need to know a little about your heart.
Basically, your heart is a pump made of special muscle. It pumps blood to all
your body's cells. This is vital, because the blood carries oxygen and
nourishment to keep your cells alive and healthy.
Your heart beats (pumps blood) because special cells in your
heart (the heart's natural pacemaker, called the sinus node) produce electrical
impulses. These cause your heart to contract and pump blood. The impulses travel
from the pacemaker cells down certain electrical paths in the muscle walls,
causing a contraction. As long as the electrical impulses flow down your heart's
walls at regular intervals, your heart pumps at a rhythmic pace. Sometimes,
though, something happens to interfere with how the electrical impulses of your
heart's natural pacemaker are made or flow down your heart. When this occurs,
the natural pacemaker can't do its job as well as it needs to.
Problems that change the heart rhythm
include:
A complete block of the heart's electrical pathway
A slow beat, an irregular rhythm
If you have a slow and often irregular heartbeat — or if
your heartbeat is sometimes normal and sometimes too fast or too slow — blood
isn't pumped around your body well. In that case your doctor may recommend an
artificial pacemaker. A pacemaker will make your heart beat more regularly. That
will help ensure that enough oxygen and nourishment gets to your body's cells.
An artificial pacemaker system has two parts: a generator and wires (leads).
The pacemaker generator is a small battery-powered unit. It
produces the electrical impulses that start your heartbeat. The generator is
implanted under your skin through a small incision. The generator is connected
to your heart through tiny wires that are implanted at the same time. The
impulses flow through these leads to your heart and are timed to flow at regular
intervals just as impulses from your heart's natural pacemaker would.
Modern pacemakers last much longer than earlier models. As
with any electronic device, your artificial pacemaker will require some care.
The batteries, for example, will wear down over time and the pacemaker will need
to be replaced. This is a minor surgical procedure. Your healthcare provider can
explain it to you.
Most pacemakers work only when they're needed. They're
called demand pacemakers. Demand pacemakers have a sensing device that shuts
them off if the heartbeat is above a certain rate. When the heart is beating
slower than the pacemaker rate, the sensing device turns the pacemaker on again.
In this way, a demand pacemaker works something like a thermostat. The
difference is that instead of working according to temperature, it works
according to your heart rate.
As the batteries wear down, your pacemaker will slow down,
but it won't stop right away. Using a special analyzer, your doctor can detect
the first warning that the batteries are running down. This can be done before
you can detect any changes yourself. A sudden, major slowing down of your heart
rate, which you may detect, probably indicates a more serious problem. If that
occurs, call your doctor.
Courtesy American Heart Association
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