Pacemaker Implant (Cardiology)

Body Area: Arms / Hands
Body Parts: Shoulder
Symptoms: Swelling
The normal heart is driven by its own natural pacemaker which lies in the right atrium, that keeps the heart beating throughout life. If the natural pacemaker tissue becomes damaged, the heart will not beat normally, and an artificial pacemaker must be inserted surgically. The procedure is done under local anesthesia and does not require more hospitalization than possibly an overnight stay. The battery for the pacemaker is placed under the skin, usually in the left shoulder (though it could be implanted in other locations), through a small incision (which is then closed with sutures). The pacemaker wires that connect to the battery are passed through a vein into the chambers of the heart that are to be paced. Both the battery and the pacemaker wires are completely under the skin when the procedure is done. Once in place, the pacemaker will pace the heart if it does not pace itself. There is ordinarily no restriction on activities that are allowed once the healing process has completed. The battery will gradually lose power over time (just like a flashlight) and will eventually need to be replaced, so it is necessary to have the pacemaker checked on a regular basis to determine when it will need to be replaced. The pacemaker function can be assessed painlessly by a device that measures many parameters of the pacemaker through the skin. This allows doctors to tell what the patient's rhythm is, how well the pacemaker is functioning, and when the battery needs to be replaced. Surgery to replace a battery is minor and is done under local anesthesia. Battery life for modern-day pacemakers can be 10 or 20 years, depending on how much the pacemaker is used.