Pacemaker
A pacemaker, also known as a cardiac pacing device, is a small device with two parts that are inserted into the heart or under the skin to regulate irregular heartbeats.
What is the function of a pacemaker?
Pacemakers are used to control malfunctions of the electrical signals of your heart. The sinoatrial node is responsible for creating the electrical signals that make your heart beat in a regular rhythm. Each chamber of the heart beats synchronously, but when these start to malfunction, it can lead to irregular heartbeats or heart failure where the heart cannot beat on its own.
What are the types of pacemakers?
Pacemakers come in different forms to treat various cardiac conditions. The range of pacemakers available includes:
- Single-chamber pacemaker: A pacemaker with a single lead (wire) attached to one chamber of your heart.
- Dual-chamber pacemaker: A pacemaker with two leads (wires) attached to two chambers of your heart.
- Leadless pacemaker: A wireless pacemaker inserted into your heart and attached to the inner wall using a catheter.
- Biventricular pacemaker: A pacemaker with three leads attached to two ventricles and the right chamber.
Temporary vs Permanent Pacemakers
Dr Sigauke specialises in the insertion of both temporary and permanent pacemakers. The device you receive depends on the severity of your condition and whether you are eligible for a permanent pacemaker.
Temporary pacemakers are used when the heartbeat has temporarily gone out of rhythm. However, they can also act as a bridge to getting a permanent pacemaker. Temporary pacemakers can last from a few weeks to a few months but run the risk of complications due to their being short-term.
Permanent pacemakers perform, look and are implanted similarly to temporary pacemakers but last for years. These are used if you have a permanent arrhythmia condition or your heart cannot function properly on its own.
What conditions do pacemakers treat?
The primary purpose of a pacemaker is to regulate slow heartbeats, also known as bradycardia. However, pacemakers can assist with several cardiac conditions, including:
- Heart failure
- Irregular heartbeat (too fast or stops)
- Heart block (when the heartbeat or electrical signal is blocked)
Dr Sigauke will perform a comprehensive physical examination and several tests before confirming that you are a candidate for a pacemaker. These tests include an echocardiogram, an electrocardiogram (ECG), an exercise stress test and holter monitoring.
Symptoms to look out for include:
- Dizziness
- Fatigue
- Chest pain
- Heart palpitations
- Difficulty breathing
- Fainting spells
Should you be experiencing any of these symptoms, contact Dr Sigauke to set up a consultation, and he will advise on a diagnosis and treatment plan.
What is the procedure for receiving a pacemaker?
There are 2 primary procedures for inserting a pacemaker that Dr Sigauke provides.
Transvenous MethodThe transvenous procedure is the most common method for receiving a pacemaker. This involves the use of catheters that transport electrodes and leads (wires) to your heart via a vein in your neck or groin area.
As this is an invasive procedure, Dr Sigauke will first supply you with a sedative and local anaesthesia to numb the area. After cleaning the insertion site, he will make an incision and thread the leads through the vein and into your heart. Dr Sigauke will monitor the progress and direction of the wires through a monitor providing an X-ray of your chest.
Once he has reached the heart, Dr Sigauke will attach the electrodes to the heart muscle and connect the opposite ends to the pulse generator responsible for creating the electrical signals. The pulse generator is inserted under the skin close to the incision and checked to see if it's in working order before the procedure is complete.
Epicardial MethodThe epicardial method is a less common procedure for implanting pacemakers as it involves open-heart surgery.
Dr Sigauke will administer local anaesthesia before opening your chest and attach the leads and electrodes to the outer walls of your heart rather than the inside. The pacemaker is connected to the leads and implanted under the skin on the chest or the collarbone.
Some of the common reasons for performing the epicardial method include:
- A child or infant requiring the pacemaker
- Issues with the veins making the transvenous method difficult
- A heart surgery precaution
Precautions to keep in mind
Dr Sigauke will advise you on the correct aftercare and risks involved with having a pacemaker, but some general tips to remember are:
- Avoid interacting with or being around magnets
- Keeping a cell phone or headphones close to or resting on your pacemaker
- Exposure to metal detectors
- Avoid wearing a smartwatch
- Be aware of being near specific electrical machinery
Dr Sigauke will provide you with a pacemaker identification card that you must always carry. Should you have any other queries or concerns, contact Dr Sigauke.