How Heart Pacemakers Work and Cardiac Pacing Information

Posted by admin on August 11, 2015 in Heart Health

You are now part of the 2 million holders of a pacemaker. With this device, you can once again enjoy a normal life. Previously, pacemakers were implanted only in emergencies to save lives. Today pacemakers are able to improve the lives of people throughout the globe. Through stimulation, these people can return to work, care for their children and grandchildren, hobbies and travel. Most of them are able to have a normal life.

Heart and heart problems

The heart is a hollow muscle with four chambers, two atria (upper chambers) and two ventricles (lower chambers).

The heart is divided into a right side and a left side, and is responsible for pumping blood through the body. This is necessary to irrigate every organ and tissue oxygen they need. So that the blood is collected and pumped, the heart depends on electrical pulses high to low cavities cavities.

These pulses start the sinus node, which is also known as the natural pacemaker. Then, the sinus node coordinates contractions and gives rhythm to the heart. The pulses pass high to low cavities cavities which then contract. This contraction is called the beating of the heart. At rest, a healthy heart beats between 60 and 80 strokes per minute, 100,000 times a day. During physical exercise or stress, the body has a greater need for oxygen. To adapt to these physiological conditions, the heart rate should accelerate to over 100 rounds / minute.

Different reasons, such as age-related illness, can disturb the natural rhythm of the heart. The most common disorders are conduction problems. Thus, the heart may beat irregularly and / or too slowly. In this case, the body especially in phase of stress – will be insufficiently supplied with oxygen, causing dizziness, feeling of weakness or fatigue. The medical term for these rhythm disorders is bradycardia.

The two most common diseases are sick sinus syndrome and AV block. In sick sinus syndrome, the sinus node generates pulses of irregular way or too slowly. The heart is then not capable of adapting the heart rate sufficiently.

In the case of an AV block, the conduction of electrical signals between the sinus node (in the atrium) and the AV node (in the ventricle) can be partially or totally blocked. With a complete AV block, the electrical conduction between atrium and ventricle is interrupted. So a different center of the heart will generate a low auxiliary rhythm to ensure followed function. In these situations, the heart may be assisted by an artificial pacemaker.

The Pacemaker

Pacemakers are tailored to the patient’s specific needs. When we speak of pacemaker, there is talk of a system consisting of a pacemaker and pacing leads.

The pacemaker pulse generator is a compound of an electronic circuit and a battery. It is active only in the absence of heartbeat.

In addition, the pacemaker recognizes or detects the cardiac activity. When the pacemaker does not detect intrinsic rhythm, it triggers an electrical stimulation. The heart is so contracted. The pacemaker is connected to the heart via one or both probes.

A probe is a thin insulated wire with silicone and placed directly in the right ventricle or the right atrium. The electrical impulse is transported to the heart. The probe may also sensing cardiac activity and return the information to the pacemaker.

According to the therapeutic indication, a single or double room pacemaker can be placed. These terms are references to the system’s ability to stimulate or sense in one or two rooms. In a dual chamber system, typically a probe is placed in the atrium and another in the ventricle. So signals can be detected in both chambers at once, and one or two bedrooms can be stimulated for optimum muscle contraction. This is to ensure a resynchronization between the two chambers.

Many pacemakers automatically adjust the frequency of pulses according to the physiological conditions. These pacemakers locked frequency are provided with a sensor which analyzes the changes in the physical parameters of the body, such as running, swimming … and that result in an increase in heart rate.

In addition, the latest generation of pacemakers can also react to mental stress . Everyone has had the experience of a sudden acceleration of the heart beat or blood pressure while watching a movie or learning an unexpected event . The closed-loop stimulation , a characteristic of this type of pacemaker, heart rate can adapt to physical activity and emotional stress. The range of pacemaker products enables the physician to diagnose and treat appropriately the way arrhythmias . Through research , pacemakers today are not only technologically advanced but also safer , smaller and finer . Your doctor will give you the pacemaker that best suits your needs.


With the new technology, implantation of a pacemaker becomes easier and more secure, and takes less than an hour. Usually the doctor local anesthesia a region under the right clavicle. Then the probe is inserted carefully into a vein to the heart. As the blood vessels do not cause pain, no further anesthesia is required. In general, the control X-ray is used to properly position the sensor in the right atrium or ventricle. The probe is then connected to the pacemaker. The pacemaker is implanted just under the skin in a below the right collarbone pocket. The doctor then closes the incision with a few stitches.

The postoperative period

Normally the recovery period is short. You can have a little bit sore where the pacemaker was implanted, a painkiller can then be prescribed. This feeling of irritation will fade quickly.

But you must tell your doctor if:

The incision becomes red, warm, swollen, or purulent.
You have a fever, dizziness, chest pain, prolonged fatigue …
In addition, during the first 5 days of implantation, you should avoid sudden and large movements with the shoulder.

After the operation, you will have a first meeting to follow up with your doctor.

The electrical functions of your pacemaker will be tested. The stimulation parameters will be adjusted according to your needs. Programming is done with an external programmer only. You will have an average of one every 6 months exam. At each visit, the state of the battery and pacing thresholds will be tested.

Living with a pacemaker

Gradually, you will return to normal life.

But follow these instructions:

Take medications prescribed by your doctor
Check your pulse regularly
Go to appointments check your pacemaker
Keep on your pacemaker identification card as well at home and in travel.
Live normally

With a pacemaker, you will live normally!
You can continue your usual activities, such as gardening, cleaning, driving.
You may shower, bathe or swim.
After consultation with your doctor, you can resume your hobbies, do sports and have a normal sexual activity.
Anyway, if you do not feel well, contact your doctor.
Electrical equipment

Pacemakers are of course protected against the influences of electrical devices. If you are next to an electric system and you experience symptoms such as rapid heart rate, irregular stimulations or discomfort, move away from the system and switch off immediately.

You can still use:

TV, hairdryer radio, electric shavers
washing machines, vacuum cleaners, microwave ovens
office equipment, computers, telex … electrical appliances in the kitchen.

Caution: Ensure that all electrical appliances are in good working condition.

The phone is not restricted. For mobile phone, talk to your doctor. To prevent possible interference, place the handset against the ear that is opposite to the location of your pacemaker.

It is very important to check with your doctor the following activities:

working with heavy equipment with strong vibrations (pneumatic drill, for example)
use of firearms (hunting, for example)
electrical systems to significant electromagnetic field or highvoltage lines electric welding (welding machine)


In general, travel by plane, train or car is not a problem for pacemakers. You can travel by car, by boat, but check with your doctor if there are constraints related to remoteness.

Tell your doctor when you travel. It will give you the address clinics and hospitals close to your final destination.

If you go by plane, inform the security staff and show your pacemakers book. The staff will give you the necessary instructions to security check.

Traveling by car is not a problem. For your own safety, buckle up, your pacemaker will not be disturbed.

Appointment with your doctor.

Before any treatment, tell your doctor, dentist and other specialist you have a pacemaker.

The following interventions are inconsequential:

Mammography or sonography
Milling teeth
Warning: In the case of special procedures such as radiation, lithotripsy, transcutaneous electrical nerve stimulation TENS ~], MRI or electrical cauterization, a prior detailed analysis will be performed in the presence of your cardiologist.

Questions you ask

Can I pass through airport security systems or anti-theft detectors? Yes I do. Pacemakers are protected against the influence of external factors (for more information, ask your doctor). Anyway, you must declare that you have a pacemaker, because the metal housing may trigger the security alarm system. To be safe, let the airport staff and quickly pass the anti-theft detectors.

Can you feel the pacemaker working? No. The pacemaker operates at a low power level to stimulate the heart. Anyway, at the slightest suspicious symptoms, tell your medecln.

What is the lifespan of a pacemaker? Date replaced depends on the pacemaker type, medical conditions, and other factors. In general, life is between 5 and 10 years. Ask your doctor about the type of pacemaker you have.

What happens to you when to change it? In general, this is a safe and simple procedure that involves replacing the old with a new pacemaker.

Should the sensors be replaced? During the replacement of the pacemaker, the doctor checks the sensors and their operation. If he does not have to be changed, they are simply connected to the new pacemaker.

The pacemaker was there a need to be adjusted after implantation? It’s possible. It depends on your medical condition, and adjustment may be necessary.

Can the pacemaker indicate that the battery is low? Yes I do. Your doctor can determine the time remaining in your stack at each check-up.

How the heart and the pacemaker react in case of death? The heart can only function if it is supplied with blood and energy. In case of death, the small electrical impulses from the pacemaker will have no effect on the heart.

Can I use a mobile phone? Yes I do. You can use a cell phone but some precautions should be taken: Check with your doctor your situation. Place the phone on the side opposite your stimulated pulse sensor (do not put it in a pocket be con chest). Due to differences in telephone technology, check with your doctor.

What is the frequency of inspections? Your doctor will determine the frequency of monitoring visits. In general, every 6 months.

Can we use the household electrical devices such as microwaves, dryers, electric heating blanket,.? The normal operation of these electrical appliances c above will not damage your pacemaker. But check that the repair of these devices is done by an expert.

Can you be allergic to materials stimulated pulse sensor? Not normally. Biocompatible materials such as titanium and plastic medically tested can not react with the body.

Glossary of important terms

Coronary arteries : Arteries that supply the heart with blood.

Arrhythmia : an abnormal rhythm of the heart or an irregular bat ment .

Asystole : absence of cardiac arrest beat.

Stimulated beat : beating initiated by a stimulated pulse sensor .

Block: failure of permanent conduction or tempo rary .

Bradycardia : Slow heart rate less than 60 minutes.

Electronics : electronic components in the pacemaker responsible for the timing of the electrical pulse sent to the heart via the probes

Detection: Pacemaker Function per putting recognize the activity of the heart. If sti The emulator detects a beat, then it sends no pulse. If a pulse is sent to the heart.

Electrocardiogram: graphic representation of the electrical currents produced by the bat ments of the heart, as the pulses from the pacemaker.

Fibrillation: Fast disordered contractions of the heart muscles.

AV node: the atrioventricular node, part of the heart that leads the electrical signal to the ventricles.

Sinus Node: or sinoatrial node. The party responsible Oreil Lette right electrical impulses that cause contraction or heart beat. Also called natural pacemaker.

Headset: high cavity of the heart, the right atrium and left atrium.

Pulse: dilatation of an artery when blood is pumped through it, for the beating of the heart.

Programmer: small computer that communicates externally with the cardiac pacemaker that. This will test the activity of the pacemaker, to change the program to suit the different needs and record an ECG without any external equipment.

Probe: insulated wire carrying the PULSE electric sions of the pacemaker to the heart. Also used to return information about the ac tivity cardiac pacemaker.

Intracavitary probe: probe placed in the heart and usually at the tip of the right ventricle.

Epicardial probe: probe attached to the outer surface of the heart.

Stimulator controlled frequency: a pacemaker that responds to body movements thanks to a tor cap. This information is then used to adjust the pacemaker in this effort. The sti single heart emulators or double rooms can be locked loop frequency.

Dual chamber pacemaker: a stimulated pulse sensor that helps stimulate atrium and ventricle, restoring the proper activity of the heart. . Usually 2 probes are required, one in the right atrium and the right ventricle.

Systole: contraction of the heart allowing blood to flow through the body and organs.

Tachycardia: abnormally rapid heart rate, usually above 100 beats per minute. This quick pumping is inefficient and blood demand is not satisfied.

Ventricle: The lower chamber of the heart ventricle gau che and right ventricle. When these cavities con towing an implement, the blood is pumped through the body and the different organs.

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