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A pacemaker is a small device used to treat some arrhythmias. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. Pacemakers send electrical pulses to help your heart beat at a normal rate and rhythm. Pacemakers can also be used to help your heart chambers beat in sync so your heart can pump blood more efficiently to your body. This may be needed if you have heart failure.
You may need a temporary (short-term) or permanent (long-term) pacemaker. A temporary pacemaker is normally inserted through a vein in the neck and remains outside your body. A permanent pacemaker is placed in your chest or abdomen. This topic focuses on permanent pacemakers.
To get a pacemaker, you may need to stay in the hospital for a few hours or overnight. Once you are back home, your doctor may check your pacemaker remotely and schedule regular visits with you to check its activity.
Many people with pacemakers can return to their regular activities within a few days. You may need to avoid certain electrical devices or devices that have strong magnetic fields.
Explore this Health Topic to learn more about pacemakers, our role in research and clinical trials, and where to find more information.
Pacemakers use low-energy electrical pulses to control the rate and rhythm of your heartbeat. Traditional pacemakers send the electrical pulses through wires, also known as leads. Wireless pacemakers are a newer kind of pacemaker without wires.
Learn more about your heart’s electrical system in our How the Heart Works Health Topic.
Traditional pacemakers (also called transvenous pacemakers) have three main parts.
The device can send data to your doctor remotely. Your doctor will use these recordings to set up your pacemaker so it works better for you.
A traditional pacemaker generator is placed outside of your heart, either in your chest or abdomen. It is connected via wires to electrodes inside one to three heart chambers.
Single- and double-lead pacemakers send pulses to the right side of the heart. A biventricular pacemaker sends pulses to both ventricles and an atrium. The pulses help coordinate electrical signaling between the two ventricles to help your heart pump blood. This type of pacemaker is also called a cardiac resynchronization therapy (CRT) device.
Wireless, or leadless, pacemakers are smaller than traditional types (about the size of a large pill capsule). The pulse generator and electrodes are all in one device that is placed inside a chamber of your heart through a small tube inserted in one of your veins. No surgery is needed. Once in place, the pacemaker then sends pulses to the right ventricle.
Your doctor may recommend a wireless pacemaker if you have a slow heartbeat, or if you have an electrical block, which is when the flow of electricity to the heart is delayed between the upper and lower chambers of your heart. Depending on the type, this kind of pacemaker may sense the right atrium (upper chamber), which allows it to match the signals that it sends to the ventricle. This helps the two chambers beat in sync.
In another type of pacemaker, the electrodes are placed on the surface of your heart rather than inside your heart. This type of pacemaker requires surgery.
Learn more about the different types of pacemakers in How Is a Pacemaker Placed?
Doctors also treat life threatening arrhythmias with a similar device called an implantable cardioverter defibrillator (ICD). The device constantly tracks your heart rate. If your heart shows an irregular and very fast rhythm, the ICD delivers an electric shock to reset your heart rhythm to prevent sudden cardiac arrest. Visit our Defibrillators Health Topic to learn more.
Pacemakers are used to treat certain types of arrhythmias, as well as heart failure, a condition that occurs when the heart cannot pump enough blood to the body. Not everyone with an arrhythmia needs a pacemaker.
This animation shows how the heart’s electrical system controls your heartbeat and what can lead to heart problems that require a pacemaker. Medical Animation Copyright © 2020 Nucleus Medical Media, All rights reserved.
The most common reason people get a pacemaker is their heart beats too slowly (called bradycardia), or it pauses, causing fainting spells or other symptoms. In some cases, the pacemaker may also be used to prevent or treat a heartbeat that is too fast (tachycardia) or irregular. These problems may be caused by:
Pacemakers may also be used to help your heart chambers beat in sync if your heart isn’t pumping enough blood to your body. This can happen because of:
Before deciding to get a pacemaker, discuss your options with your doctor. You can bring along these and other questions you may have:
Children can outgrow their pacemakers. If your child needs a pacemaker, ask what will happen as they grow.
Unless it’s an emergency, you and your doctor will plan for the procedure. Tell your doctor if you have an allergy to medicines or latex and if you are taking blood thinners or other medicines. Before your procedure, make sure you and your doctor discuss the following questions.
If you will get medicine to relax or sleep during the procedure, plan to have someone to take you home. You may go home the same day or after a few days, depending on the procedure and your health.
Learn more about living with your pacemaker and how to check for problems.
The procedure may be planned ahead of time, or it may be done during an emergency (temporary pacemaker). You will be given medicine to make parts of your body numb or make you sleep during the procedure.
You may receive antibiotics to prevent infection and blood thinning medicine to prevent blood clots during the procedure. Different types of pacemakers require different procedures to place them.
Many traditional, and all temporary, pacemakers are transvenous pacemakers, meaning the wires and electrodes are threaded through your veins. A doctor will thread the electrodes and wires through the veins in your neck, chest, or thigh, to the chambers of your heart. The electrodes are put in your heart muscle. The doctor may use echocardiography or X-ray to guide the process.
Once the wires are in place, your doctor will make a small cut into the skin of your chest or abdomen. He or she will slip the device with the generator just under the skin, then connect it to the wires that lead to your heart. Your doctor will test to see if it the device works properly and then sew the cut up. The entire surgery may take up to a few hours. Watch the video below to learn more.
This animation shows how a wired transvenous pacemaker is placed. Medical Animation Copyright © 2020 Nucleus Medical Media, All rights reserved.
You probably will not be allowed to move your arm for at least 12 hours after the procedure. This will help prevent disturbing the lead and the device and let your chest heal.
With epicardial pacemakers, the electrodes are attached to the surface of the heart rather than inside its chambers. This is a surgical procedure done under general anesthesia. Your doctor will make a cut below your ribs or armpit to place the pacemaker. Epicardial pacemakers are used as a standard precaution during heart surgery.
They may also be used:
Wireless pacemakers are a newer type of pacemaker. The pulse generator and electrodes are all in one small device that is placed inside the heart.
A doctor will thread a tube (called a catheter) through a vein in your thigh up to your heart. The catheter moves the pacemaker using X-ray images to place it in a heart chamber.
The procedure often takes less than an hour, and you may be able to leave the hospital the same day. Typically, the recovery time is faster and the risk of infection is lower. The battery life of the device is between 8 and 13 years.
After getting a permanent pacemaker, you will recover in the hospital for a few hours or overnight. Your healthcare team will tell you about any precautions or problems to watch out for during your recovery. You will receive a card with information about the device and its settings, your doctor, and the hospital where you got it. Be sure to carry this card with you at all times.
If you have a permanent pacemaker, you may have to stay in the hospital overnight so your healthcare team can check your heartbeat and make sure your device is working well. Your healthcare team may help you get up and walk around.
The day after the procedure, you may get an X-ray to check that the pacemaker and wires stay in place. Your team may also suggest an electrocardiogram to look at your heart rhythm. They will check to make sure the device is programmed correctly for you before you leave. They may also make sure the device can send data remotely.
Your doctor will give you instructions to follow as you heal at home, such as:
The procedure to place a pacemaker is generally safe. However, complications can happen from the procedure or the pacemaker itself. Talk with your doctor about the benefits and risks of a pacemaker. Complications may include:
A pacemaker can improve daily life for many people. Once you have a pacemaker, you will need regular doctor visits to check your health condition and the pacemaker. Carry your pacemaker ID card with you for emergencies. Show it to airport security, new doctors, or other people who need to know about your device. The card should have information on the type of pacemaker and leads you have, when you got the pacemaker, and your doctor’s contact information.
You may need to visit your doctor several times a year to check your pacemaker. In between visits, your doctor may be able to check that the battery and wires are still working.
You may also need to come in if your doctor needs to reprogram the pacemaker. You can check with your doctor regularly about device software updates and upgrades.
If you have a pacemaker, avoid close or prolonged contact with electrical devices or devices that have strong magnetic fields. These devices can disrupt the electrical signaling of your pacemaker and stop it from working properly. You may not be able to tell when this happens.
To be safe, keep your pacemaker at least 6 inches away from such devices or only use them briefly, when needed.
If something disrupts your pacemaker, step away from whatever is disturbing it to help your pacemaker return to normal. Talk to your doctor right away about what else to avoid, as any kind of powerful electrical or industrial equipment can interfere with your pacemaker. This includes welding machines or electric fences for pets.
Medical and dental procedures that can affect your pacemaker include:
The effects depend on what type of device you have. Always tell your doctor or dentist that you have a pacemaker and show them the device ID card. They may be able to make certain changes if you need the procedure or test.
It is important to pay attention to any changes or unusual patterns in your pacemaker. Call your doctor if you think there is a problem.
The National Heart, Lung, and Blood Institute (NHLBI) leads or sponsors many studies aimed at preventing, diagnosing, and treating heart, lung, blood, and sleep disorders.
Learn more about participating in a clinical trial.
View all trials from ClinicalTrials.gov.
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