Pacemakers are a well-known and common device vital to millions of patients that need a little extra help to ensure their hearts stay in rhythm. They are used to regulate a slow heartbeat or bradycardia and can be temporary or permanent. Pacemakers monitor the heartbeat and use low level electrical impulses to control it if it slows down too much.

Permanent pacemaker implantation

The implantation of a pacemaker is straightforward. Antibiotics and anticoagulants may be given during the procedure and sedation or general anesthesia will be used to ensure the least discomfort during the procedure. First, Dr. Banker will thread wires, known as leads, to the heart, through veins – the transvenous method. There may be one or two leads connected to the right side of the heart. Alternately, biventricular pacemakers will pace both ventricles and one atrium. The electrodes are placed in the heart muscle. A small incision is made and the pulse generator, or battery, is placed under the skin in the chest or abdomen.

The pacemaker is tested before the incision is closed.

Leadless Pacemakers

Wireless or leadless pacemakers, such as the MICRA device made by Medtronic, are entirely contained within the heart and do not require wires to pace the heart. This device is implanted via the use of a catheter and is about the size of a vitamin. Learn more about the Micra pacemaker.

How long will my pacemaker last?

Pacemakers today last longer than ever before and come in ever smaller packages. Most pacemakers will last between seven and 12 years but this will largely be determined by the amount of pacing that the device has to perform.

How do I know if my heart is being paced properly?

You will have periodic follow up appointments with Dr. Banker or your cardiologist to ensure that your pacemaker is functioning properly. Follow up appointments are a great time to ask any questions that you may have about your pacemaker or about your heart health. You may also be subscribed to remote monitoring – third-party monitoring of your pacemaker and notification to our office if anything seems amiss.

What happens if my pacemaker stops working?

Pacemakers are very reliable devices and there are only a few reasons why they would stop working. First, the battery could run out, in which case a new pulse generator would be implanted. We usually get notification of a low battery well in advance and can prepare for the battery swap. The leads of the pacemaker may also detach, requiring a lead extraction. Lead extraction can be performed mechanically or with the use of a laser. Learn more about lead extraction here.

Is my pacemaker compatible with MRIs

Most modern pacemakers are compatible with MRIs and you should have no issue getting the diagnostic testing you may need. However, it is always important to tell your MRI technician and other doctors caring for you that you have a pacemaker implant. You will also receive an implant card to show at airports for metal detector purposes. Of course, use common sense when around appliances that can cause interference. Not putting your cell phone in your shirt or jacket pocket and avoiding standing near microwaves, for example, are both prudent.