A pacemaker is a small, battery-powered device designed to regulate your heart’s rhythm. It acts as an “electrical backup,” monitoring your heart rate and sending tiny electrical pulses to trigger a beat if your heart is beating too slowly. A pacemaker keeps your heart from beating too slowly, but it does not treat fast or irregular rhythms like atrial fibrillation. It can also help your heart rate rise during exercise if needed.
When is a Pacemaker needed?
The primary reason for a pacemaker is bradycardia, which is a heart rate that is too slow to pump enough oxygen-rich blood to the rest of the body.
Common Indications
- Sinus Node Dysfunction (Sick Sinus Syndrome): The heart’s natural pacemaker (the sinus node) doesn’t work properly.
- Heart Block: The electrical signal is delayed or blocked as it travels from the upper chambers (atria) to the lower chambers (ventricles).
- Tachy-Brady Syndrome: Alternating periods of very fast and very slow heartbeats.
- Heart Failure: In some cases, to help the heart chambers contract in a synchronized way.
Symptoms to Watch For
If your heart isn’t beating fast enough, you might experience:
- Fainting or near-fainting spells (syncope)
- Dizziness or lightheadedness
- Excessive fatigue or lack of energy
- Shortness of breath, especially during activity
- Palpitations (a feeling that the heart is skipping beats)
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Types of Pacemakers
The type of pacemaker chosen depends on your specific heart rhythm issue:
| Type | How it Works | Best For |
| Single-Chamber | Uses one lead (wire) in either the right atrium or right ventricle. | Patients with specific rhythm issues in only one chamber. |
| Dual-Chamber | Uses two leads, one in the right atrium and one in the right ventricle. | Coordinating the timing between the upper and lower chambers. |
| Physiologic pacemaker | Paces close to the heart’s natural conduction system to mimic normal electrical flow. | Reduces the risk of cardiomyopathy (reduced heart function) by maintaining the heart’s natural conduction pathway during ventricular pacing. |
| Biventricular (CRT) | Uses three leads to stimulate both the right and left ventricles. | People with heart failure and abnormal electrical signaling. |
| Leadless | A tiny capsule placed directly inside the heart without any wires. | Patients with limited vein access or higher risk of infection. |
CONVENTIONAL PACEMAKER VS. LEADLESS PACEMAKER
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How It’s Implanted
The procedure is typically “minimally invasive” and takes about 1 to 2 hours.
- Preparation: You are usually given a sedative to relax and local anesthesia to numb the area below your collarbone.
- Lead Placement: The doctor makes a small (about 2-inch) incision in the left (or right) shoulder area and threads lead wires through a vein into the heart, guided by X-ray.
- Generator Placement: The wires are connected to the “pulse generator” (the battery/computer), which is then tucked into a small “pocket” created under the skin.
- Testing: The team tests the device to ensure its sensing and pacing correctly before closing the incision.
This educational video has been chosen by our cardiology team. Suggested or related videos displayed by the video provider are outside of our control and do not represent the views or endorsements of our physicians or clinic.
Living with a Pacemaker
For most people, a pacemaker significantly improves quality of life. After a brief recovery period (usually 4–6 weeks), you can return to most normal activities.
- Physical Activity: You can still exercise, swim, and play most sports. You should avoid heavy lifting or reaching high over your head with the arm on the pacemaker side for the first few weeks.
- Electronics: Modern pacemakers are well-shielded. It is safe to use microwaves, TVs, and computers. However, keep cell phones and smartwatches at least 6 inches away from the device (don’t put them in a shirt pocket), and 2-3 feet from an active induction stove.
- Medical Procedures: Always tell doctors and dentists you have a pacemaker. Most modern devices are “MRI-conditional,” meaning you can have an MRI, but the machine needs specific settings.
- Security: Metal detectors at airports won’t damage the device, but the pacemaker might set them off. Simply show your pacemaker ID card to security personnel.
Note: The battery typically lasts 7 to 12 years. When it runs low, the entire pacemaker unit is replaced during a simple outpatient procedure.
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MEDTRONIC – PATIENT TESTIMONIAL
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Procedure Instructions (Pre/Day of/Post)
PRE-PROCEDURE
- The night before your procedure AND the morning of your procedure please cleanse with an antimicrobial soap, like Dial or Hibiclens (can be purchased over the counter at most pharmacies).
- Nothing to eat or drink (NPO) after midnight the night before your procedure (you may take your morning medications with a small sip of water).
- Please bring a copy of your current medication list to the hospital.
DAY OF PROCEDURE
- Report to the Main Registration Desk at El Camino Hospital
- El Camino Hospital. 2500 Grant Road, Mountain View CA 94040 | (650) 940-7000
- You will be observed for several hours after the procedure and possibly be admitted for overnight observation. Please bring an overnight bag, just in case.
- If you are kept overnight, you will be discharged from the hospital in the morning the next day. Please arrange a ride home from the hospital.
POST-PROCEDURE
- You will get detailed instructions upon discharge about wound care and activity restrictions.
- You should have a post-op appointment scheduled with your electrophysiologist already, about 7-11 days after your procedure.
If you have any questions, please contact our office at (650) 853-2975, Monday-Friday 8:30am-4:30pm.