Pacemaker
A pacemaker is a small battery-operated electronic device, implanted in the chest below skin to help regulate heart rate. This device senses when the heart is beating too slowly. It sends a signal to the heart that makes the heart beat at the correct rate.
Pacemakers have 2 parts: Pulse generator and the leads.
The pulse generator contains the battery and the software to control the heartbeat.
The leads are wires that connect the heart to the pulse generator and carry the electrical signal to the heart.
Pacemaker procedure takes about 60 mins in most cases. The patient will be awake during the procedure as it is done under local anaesthesia. A small cut is made on the skin. The pacemaker generator is then placed under the skin below the collarbone.
Dual-chamber pacemakers have two leads, placed in the right top and right bottom chamber of heart. They act synchronously to mimic the natural sequential physiological contraction of the upper and lower chambers of the heart. Experts urged physicians to consider the use of dual-chamber pacemakers instead of single-chamber pacemakers in patients with sinus node (natural pacemaker of the heart) problem or atrioventricular block (upper and lower chamber electrical disconnection) to improve quality of life.
Dual-chamber pacing results potentially important benefits in populations with SSS and/or atrioventricular block compared with single chamber pacemakers.
Advanced pacemakers have sensors that detect body motion or breathing rate, which signal the pacemakers to increase heart rate during exercise, as needed.
In a single-chamber system, one lead is used, most commonly pacing the right bottom chamber of heart. Single chamber pacemakers are primarily used in patients with chronic atrial fibrillation where upper chamber is not pumping. Rest of the patients without atrial fibrillation are advised to go for dual chamber pacemaker.
Pacemaker syndrome is a problem with single chamber pacemaker in which a patient feels symptomatically worse after pacemaker placement and presents with progressively worsening symptoms of heart failure. This is mainly due to the loss of normal pumping sequence of the upper and lower chamber of the heart. In single chamber pacemaker this natural sequence is no longer maintained and only lower chamber works with the pacemaker. And patient needs an upgradation to double chamber pacemaker.