• Pacemakers & Atrial Fibrillation

    If you have sick-sinus syndrome, your doctor may recommend a pacemaker to help keep your heart beating as it should. 

    If you have atrial fibrillation  and have not had success with medications, your doctor may discuss other treatment options for managing your condition. One option that might be recommended, particularly if you have sick sinus syndrome  (also known as tachycardia-bradycardia syndrome), is a pacemaker.

    What Is a Pacemaker? 

    A pacemaker is a small, battery-powered device that will help keep your heart beating regularly. If you and your doctor decide that a pacemaker is right for you, the device will be implanted under your skin, near your heart. The pacemaker’s job will be to monitor your heart rate and send electrical impulses to your heart.

    How a Pacemaker Helps 

    Under normal circumstances, the heart’s own natural pacemaker (the sinoatrial, or SA, node) produces electrical impulses that stimulate the heart to beat normally. (This is called normal sinus rhythm.) However, in some people, the SA node sends out irregular signals that affect the heartbeat. Instead of beating normally, the heart may beat too quickly and then slow down. This irregular rhythm may make you feel dizzy and weak or lightheaded, or it may feel like a fluttering sensation in your chest. Some people even lose consciousness.

    The job of a mechanical pacemaker is to mimic the action of the SA node and to stimulate the heart to beat normally. The pacemaker has two parts:

    • A pulse generator, which houses the battery and the circuitry that creates the impulses that are sent to the heart.
    • The leads (also known as electrodes). Typically, two or three small, flexible wires are placed in inside the heart. These wires deliver electrical impulses to the heart muscle.

    If you have a pacemaker, it will continuously monitor your heart. If your heart rate dips too low, then the pacemaker will send an impulse to the heart that speeds it up as appropriate. The pacemaker can also sense body motion and breathing rate, so that during periods of exercise, for example, the pacemaker can allow the heart to beat more quickly as needed.

    Types of Pacemakers 

    There are several types of pacemakers. They vary in complexity, depending on how much help your heart requires and the area of the heart that needs assistance. Your doctor will work with you to determine the type of pacemaker that is right for you.

    • Single-Chamber Pacemakers: The single-chamber pacemaker is the simplest type of pacemaker. It creates electrical impulses that are carried to the lower right heart chamber (the right ventricle).
    • Dual-Chamber Pacemakers: In addition to needing help staying in rhythm, some hearts need help coordinating the timing of contractions of the heartbeat. A dual-chamber pacemaker carries impulses to both the lower right heart chamber (the right ventricle) and the upper right heart chamber (the right atrium).
    • Biventricular Pacemakers: If you have heart failure  or if the electrical system of your heart has been badly damaged, your medical team may recommend a biventricular pacemaker. This pacemaker stimulates both of the lower chambers of the heart (the left and right ventricles) at the same time. A biventricular pacemaker basically resets the heart with each beat. You may hear it referred to as cardiac resynchronization therapy, or CRT.

    What Are the Benefits & Risks of Pacemakers  

    The main benefit of a pacemaker is that it keeps your heart beating rhythmically, allowing you to go through your day without the disconcerting symptoms of an irregular heartbeat. In this respect, the pacemaker also brings peace of mind.

    Another benefit is that a pacemaker does not require open-heart surgery for implantation. A pacemaker is implanted while you are sedated so you will not feel any pain. Recovery also takes less time than open-heart surgical procedures.

    Once your doctor has confirmed that your pacemaker is responding as it should, he or she can give you permission to return to normal activities. Many people whose routines included regular exercise are able to resume physical activity without worry and without fear of their symptoms interfering with their workouts.

    It is important to note that no medical procedure is without risks. A pacemaker is no exception. Some of the complications that may developed after a pacemaker has been implanted include:

    • Infection at the wound site or in the chest near the pacemaker
    • Swell, bleeding or bruising around the site where the pacemaker has been implanted, particularly if you have been taking anticoagulant medications.
    • Problems with the device: While very rare, it is possible that one of the pacemaker’s wires could slip out of place or the device could fail. If this ever happens, you would need to have a new device implanted.

    Complications are also possible during the implantation procedure. It is very rare, but a heart attack, stroke or collapsed lung are possible. In this situation, emergency surgery is necessary.

    Device Recalls

    It happens rarely, but there are occasions when a particular medical device, or some component, is recalled. If this were to happen with your pacemaker, you would be notified by the device manufacturer and probably by your doctor as well. The recall may be as simple as a physical exam and some quick tests on the device. At worst, the device might needs to be removed and replaced. However, because of the U.S. Food and Drug Administration’s review process, it is rare that pacemakers are recalled.

    Ask Questions  

    Your medical team will discuss the benefits and risks of pacemakers with you. It is always a good idea to have a family member with you when discussing a procedure. Together you can take notes and ask all of your questions.

    Learn More About Pacemakers  

    To learn more about pacemakers, check out these articles here on SecondsCount: