Pacemaker Implantation

Pacemakers are indicated for patients who have a cardiac arrhythmia known as bradycardia, which is a slower-than-normal heart rhythm. A pacemaker monitors the rhythm of the heart and paces it by firing small electrical signals that stimulate the heart to beat normally. Modern pacemakers can adjust to a patient’s lifestyle by firing and alternately remaining dormant when necessary. With fine-tuning and calibration, patients can live a very normal life and experience a normal heartbeat for years or even decades.

Today’s pacemakers are smaller and more efficient than ever before. At our practice, we offer two kinds of pacemakers: ones that connect the battery, or pulse generator, to the heart using leads, and another that is self-contained and leadless, including the smallest pacemaker on the market known as the Micra.

Implanting a pacemaker with leads

The pacemaker implantation process is relatively simple and straightforward. Electrical wires or leads are connected to the heart via a vein and affixed permanently. The leads are then connected to a battery with a circuit known as a pulse generator, which provides power and monitors the heart.

The pulse generator is about the diameter of a quarter and sits immediately under the skin, near the collarbone, attached to the muscle wall. After a short acclimation period, most patients forget that their pacemaker is even there and continue with normal life.

Leadless pacemaker implantation

A leadless pacemaker as the name suggests, requires no leads connecting to the heart and is a self-contained device. The leadless pacemaker is deployed using a catheter-based delivery system and advanced imaging. Learn more about the Micra leadless pacemaker. Your EP will discuss whether a leadless pacing system is appropriate for your circumstance.

Battery Life

The batteries in today’s traditional pacemakers last about 10 years, on average. Of course, as with any medical device, there is some variance and patients may experience longer or shorter device life. Once the battery of the device has expired, a quick procedure to replace the power source is necessary. The Micra leadless pacemaker has a 50-100% longer battery life.

Monitoring the Pacemaker

Today’s pacemakers have new and exciting features, including the ability to transmit information to our office for review by your electrophysiologist. Depending on your pacemaker and specific condition, we may require data from your pacemaker.

Risks of pacemaker implantation

For patients that suffer from bradycardia, the benefits of a pacemaker very often clearly outweigh the risks. However, as with any procedure, there are some risks and considerations the patient should be aware of:

• First, as with any procedure that requires incisions, no matter how minor, there is the risk of pain, blood loss and infection. Due to the less-invasive nature of pacemaker implantation, this is fortunately quite rare and easily managed.
• Patients may also experience varied longevity of the pacemaker. While medical devices today are made to exceptionally-precise, exacting standards, not all devices live up to expectations and may need to be replaced sooner than expected.
• Traditional pacemakers may detach from the appropriate part of the heart and no longer offer the appropriate pacing.
• The catheter used to deliver the leadless pacemaker may damage the blood vessel or the heart structure.

The Bottom Line

Candidates for pacemaker implantation usually derive very clear benefit from their use. Both lead and leadless pacemakers can be deployed with few risks and offer exceptional benefits for years or even decades.