When You Need a Pacemaker for Your Heart

If your heart has trouble maintaining a normal heart rate, it may need help from a pacemaker. These devices may treat several types of arrhythmias — abnormal heart rhythms.

“Pacemakers work by sending electrical pulses to your heart, mimicking the electrical signals your heart naturally produces to regulate rhythm,” says Dr. Stuart Smalheiser, board-certified cardiologist at Beaufort Memorial Heart Specialists. “Most importantly, you get peace of mind knowing that your heart is receiving the help it needs to deliver blood to the rest of your body.”

Read More: What Your Irregular Heartbeat May Be Telling You

How Does a Pacemaker for Your Heart Work?

Your heart runs on electrical pulses that cause it to beat at a particular rate. These pulses often originate from a structure called the sinoatrial (SA) node. Located in the right atrium, one of the heart’s two upper chambers, the SA node sends an electrical signal that causes the atria to contract. The signal then travels to the heart’s lower chambers, the ventricles, and they contract, completing a heartbeat.

An arrhythmia occurs when the heart’s electrical system doesn’t work normally. That can happen if the SA node malfunctions. Likewise, arrhythmias can occur if a problem along the heart’s electrical pathways interferes with the electrical signals or from heartbeats generated from other parts of the heart.

A pacemaker picks up the slack if your heart has trouble transmitting electrical signals naturally. These devices use battery power to produce electrical pulses that help your heart pump at a normal pace. Your physician can monitor the data from your pacemaker to see how well it’s working for you. In addition, he or she can use this information to adjust the device, if necessary.

What Pacemakers Treat

Arrhythmia is the most common reason for needing a pacemaker. Understanding the health of your heart and vascular system is key to understanding your arrhythmia risk. Tests such as an electrocardiogram, coronary calcium scoring and vascular screening can provide a preliminary picture of your cardiovascular health. In addition, these tests can help determine whether you need heart and vascular care to stay healthy — and reduce your risk of future problems, including arrhythmias.

“Having an arrhythmia doesn’t guarantee you’ll need a pacemaker,” Dr. Smalheiser says. “Often, it’s the last option. We have a variety of treatments we can use, including medications and lifestyle changes. A pacemaker may be necessary for some patients, especially those with a slow heartbeat.”

In addition to a low heart rate — known as bradycardia — abnormal heart rhythms that may benefit from a pacemaker include:

• Slow, irregular rhythms
• Rhythms that lead to fainting or other symptoms
• Rhythms that cause a pause in the heartbeat

Special biventricular pacemakers can also treat heart failure by helping the ventricles sync their contractions. As a result, the heart is better able to pump blood.

Read More: Living With Heart Failure

Types of Pacemakers

Temporary pacemakers can stabilize your heart rate for a short time — for example, during a medical emergency. Many patients, however, need a permanent, implantable pacemaker for long-term treatment. Implanting most pacemakers requires a procedure. Common types of permanent pacemakers include:

• Transvenous pacemakers. Historically, transvenous pacemakers have been the most common type. To implant this device, a physician places a generator in your chest. The physician threads wire electrodes into the heart through veins, and they detect when the heart isn’t beating normally. When that happens, the generator sends electrical pulses to the electrodes. That restores a normal heart rate.
• Wireless pacemakers. As their name suggests, wireless pacemakers don’t have wire electrodes. This type of pacemaker is an all-in-one device. In other words, the generator and electrodes reside in one small, cylindrical device inside the heart. It detects and reacts to abnormal rhythms.

Another type of wired pacemaker, called an epicardial pacemaker, sends electrical pulses to electrodes attached to the outside of the heart rather than located inside it.

Closely related to pacemakers are implantable cardioverter defibrillators (ICDs). Like a transvenous pacemaker, an ICD features a generator implanted in the chest that connects to the heart by electrodes. However, unlike a pacemaker, an ICD monitors the heart for dangerous arrhythmias that could lead to cardiac arrest and/or death. If one occurs, the device delivers an electric shock, rather than a low-level pulse, to send the heart back into a safe rhythm. Many ICDs can serve as pacemakers as well.

Have you experienced symptoms of a potential arrhythmia? Schedule an appointment with a member of our heart care team.