Pacemaker and Heart Arrhythmia

Pacemakers for Heart Arrhythmias

People with an abnormal heartbeat, a medical condition called heart arrhythmia, may need their heart rate regulated with a pacemaker. Pacemakers are small, electronic metal devices implanted surgically into the chest or abdomen to send electrical pulses to the heart to normalize its function.

Heart arrhythmias may arise due to age, heart disease or other factors that make the heart beat in an aberrant manner. The use of pacemakers to manage heart arrhythmias is usually recommended in cases when the heart rate falls above or below the normal range of 60 to 100 beats per minute at rest. It may be prescribed in cases of bradycardia (below 60 beats per minute of rest) or tachycardia (above 100 beats).

Pacemakers can help people with heart arrhythmias to live a longer, more dynamic life and resume some of their old activities. They can also relieve common symptoms of the disease, including fatigue and fainting.

Risks of Pacemaker Surgery

A pacemaker is usually installed in a hospital or a heart treatment facility. It is a minor surgical procedure that usually lasts just a few hours, although the patient will need to be confined at least overnight to evaluate the heart’s rhythm and check the pacemaker’s performance.

Fortunately, the risks of pacemaker surgery are very low, and recipients often return to their normal routine after a few days. Still, a person who has been recommended for a pacemaker implantation needs to know the dangers from his physician before he agrees to the procedure. Risk factors include age, state of health and the heart’s condition.

Here are some potential complications of a pacemaker insertion:

1. A collapsed lung can occur if the lung is pierced during surgery and an air leak, or pneumothorax, develops. The condition sometimes clears up without treatment; otherwise, a chest drain is called for, requiring a longer hospital stay.
2. A blood leak around the heart (pericardial effusion) may occur if fluid collects outside the heart. It may resolve on its own, but if it does not, a drain is applied to stop the leak.
3. The patient may develop an infection that needs treatment with antibiotics.
4. Severe bruising, or hematoma, is another potential risk. The blood clot may have to be drained.
5. Wire displacement may lead to a malfunctioning of the pacemaker, and usually requires another surgery to reposition the displaced wires.

Some soreness and swelling after surgery is to be expected, but this can be alleviated with painkillers.

Monitoring of a Pacemaker

Even if the surgery is successful, the patient still needs to go for regular medical checkups to ensure that his pacemaker is working perfectly. The device can malfunction for several reasons: its battery crashes, the heart disease gets worse, the wires are displaced or damaged, or the electrical signals have been scrambled by strong electrical, magnetic or radio waves given off by other devices. Checkups may be scheduled several times a year and may include an electrocardiogram (ECG) to assess electrical activity in the heart.

References

The London Arrhythmia Centre: www.londonarrhythmiacentre.co.uk/treatments-pacemakers.html

National Institutes of Health: www.nhlbi.nih.gov/health/dci/Diseases/pace/pace_whoneeds.html

Cardiology Associates: www.cardioassoc.com/patient_pgs/procedures/pacemaker.asp