Pacemaker And MRI What Are They?

What are pacemakers?

A cardiac pacing device or a Pacemaker is a small, battery-powered device that is implanted in the chest, near the collarbone. The implant process is done using the surgical method. The main role of this device is to help the patient to have normal rates of heartbeats (60-100 bpm). The patients who have been prescribed this device generally face the issue of low or high heartbeats per minute.

What are the different types of pacemakers?

There are three distinct categories of pacemakers: single chamber, dual chamber, and biventricular pacemakers. Each one does the same job but in different areas of the heart. 

• Single chamber pacemaker - This is one of the most commonly prescribed pacemakers for patients dealing with heartbeat-related problems. It is a pacemaker, but as the name suggests, it only has one lead, which means that it only connects the pulse generator to one chamber of your heart. Either the lead is connected to the lower heart chamber or the right ventricle, or it is connected to the upper heart chamber or the right atrium. Placing the lead depends on your symptoms, conditions, and the type of pacing the patient needs.
• Dual chamber pacemaker - This pacemaker has two leads as the name already says, and it is connected to both the chambers in the right portion of your heart (right ventricle and right atrium). This pacemaker helps the two chambers to work with coordination efficiently by making both the chambers contract and relax in a rhythmic manner. This contraction helps in proper blood flow from the right atrium to the right ventricle.
• Biventricular chamber pacemaker - This pacemaker is also popularly known as CRT or Cardiac Resynchronization Therapy. It is used for resynchronizing the coordination between both ventricles. It has three leads, attached to the right atrium and both the ventricles. This is mainly prescribed to patients with arrhythmias, caused by heart failures, in which the left and the right ventricle do not pump the blood simultaneously. This pacemaker is specially programmed in such a way that it will help the patient’s heart to coordinate the contractions of the ventricles so that they both can pump blood simultaneously.

How do pacemakers work?

Before you know how pacemakers work, it is important to know how a healthy heart works. The heart has an electrical conduction system of its own that is also known as the sinoatrial or SA node. It serves as the natural regulator of the body's rate of heartbeat. It signals the heart to contract and relaxes through electrical impulses. 

The SA node controls the heartbeat by determining the contractions of the atria and ventricles chambers. The conduction system refers to the entire pathway that the electrical impulses travel through to reach the ventricles; this pathway is narrow and comprises the AV node in addition to a couple of bundle branches. 

The SA node is responsible for producing electrical signals. The malfunctioning of the conduction system is when the patient requires an artificial conducting device, a pacemaker. 

A pacemaker helps in stabilizing the heart rate by generating a pulse artificially. They are implanted below the collarbone and connected to the heart through the veins near the collarbone by the electrical lead. The electrical leads then monitor the heartbeats and treat the rhythm disturbance automatically when needed.

Does it require major surgery?

In most cases, implanting a pacemaker is a minor surgery that might only take around two hours to perform. It does have some chances of complications but those are very rare and you don't have to worry about it at all if you have a well-experienced surgeon. You will most probably be awake throughout the surgery but you won't feel any major pain as you will be injected with local anesthesia to numb the incision site.

What are the signs you need a pacemaker?

Pacemakers are typically used to treat patients suffering from slow heartbeats. Due to the malfunctioning of the conduction system, the bundle branches may get blocked, causing the heart to beat too slowly or irregularly, without any rhythm. Some of the symptoms of a slow heartbeat are:

• Dizziness
• Shortness of breath
• Pass Out

So you may need a pacemaker if you are addressing these symptoms regularly.

What are the possible benefits?

One of the most possible benefits of the pacemaker is that it can eliminate the symptoms of bradycardia or slow heart rate. This means that the patient may not face any symptoms like shortness of breath or dizziness after the implant. However, it is not the cure as it only helps to improve life in the short term and may not be very helpful in the long term. It will just help the patient’s heart to function properly but it will not make the patient free from the risk of any other heart disease or heart attacks. 

What are the possible complications or side effects of having a pacemaker?

Having a pacemaker has indeed a very blissful advantage but it also has some common side effects that are important to know about. Some of the common complications of having a pacemaker are: 

• Infections near the area where the pacemaker is placed.
• Damage to the nerves or vessels near the pacemaker.
• An allergic reaction may occur due to the anesthesia or the dye that is used during the surgery.
• Swelling, bruising, or bleeding at the area where the device is placed.
• The lungs may also collapse due to pneumothorax.

What is the life expectancy of a person with a pacemaker?

A recent study shows that the average survival rate of patients after the implantation of a pacemaker is approximately 8.5 years or 101.9 months to be exact. But the numbers may vary depending on the lifestyle, age, and health of the patient.

• After 5 years of implantation, around 65% of the patients survived.
• After 10 years of the implant, more than 44% of the patients survived.
• After 15 years of implant, 30% of the patients were still healthy.
• And after 20 years of the implant, 21% of the patients were still alive.

WHEN TO CALL THE DOCTOR - Sanar Care (Cardiologist)

After the implant, you must stay in touch with your doctor if you face any of the problems mentioned below: 

• Pain, infection, swelling, redness, etc in the area of the incision.
• Internal pain in the chest area.
• Continuous Hiccups that do not tend to go away.
• If you become momentarily unconscious.
• dizziness, shortness of breath, or any other symptom that you may have faced before the implant.

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