What is a Pacemaker?

A pacemaker, or cardiac pacing device, is a small medical device that's placed (surgically implanted) in the chest to help control the heartbeat. A pacemaker generates electrical impulses that cause the heart muscle chambers to contract and pump blood, regulating the electrical conduction system of the heart. Implanting a pacemaker in the chest requires a surgical procedure.

Almost all pacemakers are used to treat a slow heartbeat, which is called bradycardia. Your doctor may recommend a temporary pacemaker when you have bradycardia after a heart attack, surgery or medication overdose, but your heartbeat is otherwise expected to recover. A pacemaker may also be implanted permanently to correct a chronic slow or irregular heartbeat, or to help treat heart failure.

At rest, the heart usually beats about 50 to 70 times each minute, and the heart rate may increase two to three-fold during stress or exercise. If the heart beats too slowly, the brain and body do not get enough blood flow and a variety of symptoms may result.

• Fainting

• Near fainting

• Dizziness

• Lack of energy

• Fatigue

• Shortness of breath

• Exercise intolerance

Extreme slowing or complete stopping of the heartbeat can be fatal. In other cases, people may have no symptoms but are at high risk for dangerously slow heart rates because of disturbances of the electrical system of the heart. A pacemaker may be recommended for these people before symptoms occur.

Pacemakers work only when needed. Some newer pacemakers also have sensors that detect body motion or breathing rate and signal the devices to increase heart rate during exercise, as needed.

Modern pacemakers are very small, about the size of a man’s wristwatch, and surgically implanted under the skin just above the collarbone. Wires are placed through the blood vessel into the heart and connected to the pacemaker. The procedure usually takes about 1-2 hours, and the risk of complications is about 1-2%. Usually, a small bump in the skin is seen over the skin where the pacemaker has been implanted.

There are about 3 million people worldwide with pacemakers, and each year 600 000 pacemakers are implanted. With rare exception, implantation of a pacemaker does not change the recipient’s activities or lifestyle. Although most people who receive pacemakers are aged 60 years or older, people of any age, even children, may need pacemakers.

Pacemaker implantation is performed in the Cardiac Cath Lab at CCH by Cardiologists Sairav Shah, MD, FACC; and Nicholas Stamato, MD, FACC.; board certified cardiologists living and working in Gillette. Dr. Shah and Dr. Stamato practice at the Campbell County Medical Group Cardiovascular Services clinic, providing routine and follow-up cardiac care, diagnostic testing, and emergency cardiac care for patients in Northeast Wyoming. The Cardiology team includes physicians, registered nurses, the technicians in the Clinic, as well as a team of registered nurses and technicians in the Cardiac Cath Lab.