Permanent Pacemakers Correct Heart
By Malcolm Brand, MD
Our hearts come with a natural
pacemaker that regulates the rhythm of our heartbeat, slowing down when we’re
at rest and appropriately speeding up when we’re active. Some people, however,
develop faulty conduction systems in their hearts that prevent the rhythmic
electrical impulses from traveling through the heart muscle. The result is
often a heartbeat that is too slow. This condition, called bradycardia, is very effectively treated with the implantation of a
What are the symptoms of
The most common symptoms of
bradycardia are episodes of feeling light-headed or dizzy. People with slow
heartbeats can also have problems tolerating vigorous exercise. If conduction
worsens and the heart stops for brief periods of time, you can lose
consciousness. This can be very dangerous if you are behind the wheel of a car
or engaged in other activities that would put you or others at risk should you
pass out. When people drive off the road and have no memory of why, it can be
due to heart rhythm problems.
How does a permanent pacemaker
A pacemaker ensures that your heart
will not beat too slowly. The pacemaker is set at a certain limit: if your
heart beats faster, the pacemaker monitors that; if your heartbeat becomes too
slow, the pacemaker makes it beat faster. A pacemaker does not keep your heart
rate the same; it just keeps it above a set rate. There are athletes with
pacemakers who engage in strenuous activity and their heartbeats become very
rapid as their bodies demand it; their pacemakers simply keep their heart rates
from dropping too low.
How is a permanent pacemaker
In Tompkins County, permanent
pacemakers are implanted in the Cardiac Catheterization Lab at Cayuga Medical
Center. This is an invasive procedure but it is not open-heart surgery.
Patients receive a sedative and local anesthesia, which allow them to be mildly
conscious during the procedure. The cardiologist begins by making a small incision
in the shoulder. Wires from the pacemaker are inserted into the vein in the
shoulder. Using guided imagery (a form of x-ray), the wires travel down the
vein and are attached to the inside of the heart muscle. The pacemaker, which
contains a battery and computer chip, is then attached to the wires and tucked
beneath the skin on the shoulder. The patient stays overnight in the hospital
and goes home the next day. Activity is somewhat restricted for four weeks, at
which point it is safe to resume life as usual.
What are the risks of this
Like any procedure, there are risks
involved. These include bleeding, inducing abnormal heart rhythm, and damage to
the heart muscle while placing the wires. The risk of complication is about one
How is a permanent pacemaker
The pacemaker’s function and
battery are checked two to three times a year in your cardiologist’s office by
lightly running a computer wand over the skin on the shoulder. Pacemakers
typically last eight to ten years on average, though some last much longer.
Do people with pacemakers have to
worry about being around electronic devices?
Today’s pacemakers are much more
advanced than previous versions. They are better insulated from external
electrical interference, so people with pacemakers can safely use cell phones,
microwaves, and automatic doors.
What happens if I need an emergency
In an emergency situation, a
temporary pacemaker can be placed by any cardiologist on staff at Cayuga
Medical Center. This will stabilize the heart rhythm until a permanent
pacemaker can be inserted by one of the two local cardiologists certified to
implant permanent pacemakers (myself and my colleague, Dr. Lynn Swisher).
Dr. Brand is board certified in
cardiovascular disease, nuclear cardiology, and internal medicine. He is a Fellow of the American College of
Cardiology and a Diplomate of the Certification Board of Nuclear Cardiology. He
is on the medical staff of Cayuga Medical Center and in practice with Ithaca
Cardiology Associates, where he can be reached in Ithaca at (607) 272-0460. Dr. Brand completed his fellowship training, residency, and
internship at the University of Massachusetts Medical School.