What is a Pacemaker?

My name's Dr. Gupta.  I'm a cardiologist and, more specifically, an electrophysiologist, which is a heart rhythm specialist and I've been working at Atrium Medical Center for last 15 years.  And, I'm also the medical director of cardiology.

Pacemakers are fairly small, I would call it tiny, implantable devices that go under your skin, typically below your left collar bone.  There are also 2 electrical wires, typically, that are inserted or implanted into your heart via a small vein that runs below the collar bone.  The pacemakers are designed to cure slow heart beat.  So, patients who are symptomatic with slow heart beat would typically benefit from a pacemaker.  The typical symptoms could include passing out, or syncope, dizziness, lightheadedness, fatigue, tiredness, and these people, if we can document that these symptoms are caused by slow heart beat, would typically benefit from a pacemaker. 

It's a minor surgical procedure.  We call it a surgical procedure. It's done under local anesthetic and some sedation.  We don't put people to sleep. Typically, it's done in a cath lab suite, not in a surgical suite.  Most people do spend one night in the hospital after it's been done.

Typically takes anywhere from 30 to 45 minutes and, most people wake up and, you know, ask me the question, "When are you gonna do it?"  So, they don't really feel anything.

I would say, 98% of the patients report significant improvement in their symptoms, so they feel good about it.  Most people ask me what are the limitations. I tell them none, um, you know, other than the small 1 to 2 week healing period where they have to watch themselves.  Afterwards, life is normal.

Slow heart beats in our technical term is bradycardia:  Brady means slow, cardia means cardiac.

Anything lower than 60 consistently is slow.  Between 50 and slow, 60 is not considered slow enough to implant a pacemaker.  We can live with a rate of 50.  But if you start out with a rate of 55 and you exert yourself, it doesn't get up as it should, then also it is considered slow.  But most people who are candidates for pacemaker, their heart rates are well below 50, typically in the 40s.