Heart devices
Pacemaker implantation
Single- and dual-chamber pacemakers used when the heart beats too slowly: assessing the indication, implantation and follow-up.
A pacemaker (cardiac pacemaker) is a small device that keeps the heart at the right rate when it beats too slowly.
It monitors the rhythm all the time and sends an impulse only when the heart slows down. The device has two parts: a small metal case that holds the battery and the electronic circuit, and thin wires (leads) that are passed to the heart.
How a pacemaker is built
A small housing and thin wires passed to the heart — the leads.
- HousingA small metal part that holds the battery and the electronic circuit.
- Right atrial lead
- Right ventricular leadA single-chamber device has one lead, a dual-chamber device has two.
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Difference between single- and dual-chamber pacemakers
Single-chamber
one lead. It is placed in the right atrium when the signal starts in the sinus node but is slow, and in the right ventricle when the rhythm does not start in the sinus node (for example, in atrial fibrillation).
Dual-chamber
two leads, in the right atrium and the right ventricle. It is used when the signal is blocked between the atrium and the ventricle (AV block) and makes the two chambers work in step.
The doctor will tell you which type is suitable after the tests.
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Who may need it
People with sinus bradycardia or AV block, especially if there is weakness, dizziness or fainting. The cause is looked at first (for example, a medicine that slows the rhythm). If it cannot be removed or this is not enough, a pacemaker may be needed.
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How the implantation goes
It is usually done under local anesthesia with a sedative, and the patient stays awake. A small incision is made on the left side of the chest, the device is placed under the skin near the collarbone, and the leads are passed to the heart under X-ray guidance. Duration: according to EHRA usually 1–2 hours, according to the NHS usually about an hour. Risks such as bleeding at the incision site, infection or lead displacement are explained at the appointment.
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After implantation
The check-up schedule differs between sources: EHRA says the first check at 2–12 weeks, then usually once a year; the NHS says about 6 weeks, 3–6 months, then at least once every 12 months. Follow your own doctor’s schedule. Always carry your device card with you.
The exact procedure, price and preparation are agreed with the doctor or administrator at the appointment.
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