A permanent pacemaker is a small electronic device used to treat slow heartbeat (bradycardia) or conduction disorders. This device, placed under the chest skin, ensures the heart beats regularly.
What is a Pacemaker?#
A pacemaker is a small device that monitors the heart’s electrical activity and delivers electrical stimulation when needed. It consists of two main components:
- Generator (Battery): Contains the battery and electronic circuits
- Electrodes (Leads): Wires that transmit electrical stimulation to the heart
Modern pacemakers are credit card-sized and can work for 8-15 years.
Who Needs a Pacemaker?#
Indications#
Bradycardia (Slow Heart Rate):
- Sinus node dysfunction (sick sinus syndrome)
- Symptomatic bradycardia
- Chronotropic incompetence
Heart Blocks:
- Complete AV block (3rd degree)
- Advanced 2nd degree AV block
- Symptomatic 1st degree AV block
Other Conditions:
- Carotid sinus hypersensitivity
- Neurocardiogenic syncope
- Certain cardiomyopathies
Symptoms#
Symptoms of conditions requiring a pacemaker:
- Dizziness
- Fainting (syncope)
- Fatigue
- Shortness of breath
- Exercise intolerance
- Confusion
Types of Pacemakers#
Single-Chamber Pacemaker#
- Single electrode (usually right ventricle)
- Simple bradycardia treatment
- Chronic atrial fibrillation + bradycardia
Dual-Chamber Pacemaker#
- Two electrodes (right atrium + right ventricle)
- Preserves AV synchrony
- More physiological pacing
- Most commonly used type
Three-Chamber Pacemaker (CRT)#
- Three electrodes (right atrium + right ventricle + left ventricle)
- Heart failure treatment
- Cardiac resynchronization
Leadless Pacemaker#
- Wireless, capsule-shaped
- Placed directly in the heart
- In selected patients
How is Pacemaker Implantation Performed?#
Pre-Procedure Preparation#
- Blood tests
- ECG and echocardiography
- Chest X-ray
- Adjustment of anticoagulant medications
- Fasting (6-8 hours)
Procedure Steps#
- Local anesthesia: Area below collarbone is numbed
- Pocket creation: Pocket for battery is created under skin
- Vascular access: Subclavian or cephalic vein is used
- Electrode placement: Placed in heart under fluoroscopy guidance
- Testing: Proper function of electrodes is verified
- Generator connection: Electrodes are connected to battery
- Pocket closure: Skin is closed with sutures
Procedure Duration#
A typical pacemaker implantation takes 1-2 hours.
Post-Procedure Care#
In Hospital#
- 24-48 hours observation
- Chest X-ray control
- Pacemaker programming
- Wound care
After Discharge#
First 4-6 Weeks:
- Don’t raise arm above shoulder level
- Don’t lift heavy objects (>5 kg)
- Keep wound area dry
- Don’t drive
Long Term:
- Regular check-ups (every 6-12 months)
- Carry pacemaker ID card with you
- Consult your doctor before MRI
- Don’t keep cell phone on pacemaker side
Pacemaker Risks#
Procedure risks are low but may include:
Early Complications:
- Bleeding or hematoma
- Infection
- Pneumothorax (lung injury)
- Electrode dislocation
- Heart perforation (rare)
Late Complications:
- Electrode fracture
- Pocket erosion
- Venous thrombosis
- Pacemaker syndrome
Living with a Pacemaker#
You can lead a normal life with a pacemaker:
What You Can Do:
- Normal daily activities
- Exercise and sports (with doctor approval)
- Travel (including flying)
- Sexual activity
- Shower and bath
Things to Consider:
- Avoid strong magnetic fields
- Inform security when passing through airport gates
- Consult your doctor before certain medical procedures
- Attend regular check-ups
Frequently Asked Questions#
Is pacemaker implantation painful?
How long does a pacemaker last?
Can I have an MRI with a pacemaker?
Can I exercise with a pacemaker?
How often are pacemaker check-ups done?
Appointment and Contact#
If you would like to schedule an appointment for pacemaker evaluation or implantation:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Arrhythmia Treatments#
Other arrhythmia treatments related to permanent pacemaker:
- Temporary Pacemaker - Temporary pacing
- Biventricular Pacemaker - CRT pacemaker
- ICD - Implantable cardioverter defibrillator
- Holter - 24-hour rhythm monitoring
- EKG - Electrocardiography