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Pacemaker implantation treats arrhythmia and restores normal rhythm

The heart can beat continuously automatically from the function of special cells that can generate electrical impulses by themselves (pacemaker cells). If such cells cannot transmit electrical impulses in the normal direction, it will cause arrhythmia that must be treated with pacemaker implantation so that the patient can return to having a good quality of life as before.

Key Takeaways

A pacemaker is an electronic device implanted under the skin to treat patients with arrhythmia and bradycardia, allowing the heart to function close to normal.

Pacemaker implantation involves inserting leads to the heart through a vein. When the leads are connected to the pulse generator, the device is implanted in the patient’s chest area.

After implantation, if there are symptoms such as sudden shortness of breath, dizziness, fainting, or the wound appears swollen and red, a doctor should be consulted immediately.

What is a pacemaker, and why should patients with arrhythmia have one?

A pacemaker is an electronic device implanted in the chest wall of the patient. It consists of a pulse generator, electrical leads, and a battery. The pacemaker functions to generate electrical impulses when abnormalities in electrical conduction from the atria to the ventricles are detected, including abnormalities of the cardiac electrical origin with alternating fast and slow heart rates.

This helps the heart beat more regularly, enabling sufficient blood circulation to other organs, and preventing symptoms of abnormal slow heart rate such as fatigue, weakness, dizziness, or palpitations, which may progress to fainting.

How does a pacemaker work

When the heart beats normally, signals are transmitted through the leads to the pacemaker, causing it not to release electrical impulses. However, when the heart beats more slowly or irregularly, the pulse generator releases electrical impulses through the leads to different chambers of the heart to stimulate a faster rate, helping coordinate heart function to be as close to normal as possible.

Methods of pacemaker implantation

For patients with severe symptoms who do not respond to antiarrhythmic medication and have already been evaluated by a physician and deemed appropriate for pacemaker implantation surgery, there are 2 types of pacemaker implantation as follows:

Endocardial lead placement: The physician performs surgery to insert electrical leads into the patient’s heart through the cephalic vein or the subclavian vein located beneath the clavicle. When the leads reach the heart, one end of the lead is placed on the inner lining of the heart. This requires fluoroscopic imaging during surgery to ensure proper positioning. The pulse generator is then implanted under the skin in the upper chest area of the patient. The physician then connects the leads to the pulse generator, completing the procedure. During the surgery, the patient remains conscious and may feel slight pressure during implantation, although in some cases general anesthesia may be considered.
Epicardial lead placement: This technique requires general anesthesia because the physician must perform surgery to open the left chest to attach the lead tip directly to the outer lining of the heart. The pulse generator is then implanted in the abdominal area below the rib margin or beneath the chest muscle as appropriate. However, this method is currently less commonly used. Leadless pacemaker is a newly developed pacemaker inserted through a vein in the groin via a catheter and implanted in the right ventricle, which has advantages and disadvantages and requires appropriate patient selection.

Steps of pacemaker implantation (Pacemaker implantation) and proper preparation

A pacemaker is a supportive device for patients with arrhythmia, which requires surg

Post-implantation care for faster wound healing

After pacemaker implantation, to return to normal life quickly and prevent complications, patients should take care of themselves as follows:

Take antibiotics as prescribed by the physician.

Avoid getting the wound wet for 7 days to prevent inflammation and infection.

Avoid pressing, picking, or scratching the surgical wound area.

Do not wear clothing that compresses the wound.

During the first 7 days before the wound is opened, limit movement of the arm on the side of implantation, keeping it close to the body. After that, before completing 1 month, the arm can be raised no higher than shoulder level and should not be swung forcefully. After 1 month, the arm can be used normally, but sports that may cause impact should be avoided.

Attend scheduled appointments regularly to follow up on treatment and check device function.

If abnormal symptoms occur, such as severe wound swelling and redness, discharge, high fever, sudden shortness of breath, palpitations, fainting, or frequent hiccups, seek medical attention immediately.

Pacemaker as a treatment for patients with abnormal heart rhythm

Pacemaker implantation is a treatment method for patients with arrhythmia, which causes the heart to be unable to pump blood sufficiently to supply various organs in the body. The device helps stimulate the heart rate to be faster, reducing symptoms caused by bradycardia such as fatigue, palpitations, dizziness, or loss of consciousness effectively.

If you have this condition that does not respond to medication, you can consult a physician at the Heart and Vascular Institute, Praram 9 Hospital, which provides detailed diagnosis and cardiac care services, helping restore heart health so you can return to living close to normal again.

You can contact the hospital through the following channels:

Facebook : Praram 9 Hospital International & Expats
Line : @Praram9Hospital
Tel. 1270

Frequently asked questions about pacemakers

Is pacemaker implantation risky?

After pacemaker implantation, there may be some risks of complications such as pneumothorax, lead displacement, infection, arrhythmia, excessive bleeding or hematoma under the skin, muscle weakness, frozen shoulder due to not moving the arm out of fear of pain, etc. However, these complications have a low risk of occurrence, approximately 1–5 percent only.

What precautions should be taken after pacemaker implantation?

After pacemaker implantation, precautions should be taken to avoid areas with strong magnetic fields, MRI examinations, radiation therapy or irradiation. Mobile phones should be kept about 1 foot away from the implantation site, and the pacemaker identification card should always be carried.

References

Heart Foundation. (2024, March 10). Permanent Pacemaker (PPM). https://www.heartfoundation.org.au/your-heart/permanent-pacemaker-ppm

National Institutes of Health. (2022, March 24). What Are Pacemakers?. https://www.nhlbi.nih.gov/health/pacemakers

The Mater Hospital. (n.d.). Permanent Pacemaker Implantation (PPM). https://www.mater.ie/docs/services/cardiology/Pacemaker%20v1.0%20Aug%2022.pdf

About the Author

Praram 9 Cardiovascular Institute

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Arrhythmia

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