A pacemaker will put in an electrical impulse to cause the heart to beat if it pauses or goes too slowly. It cannot slow the heart down – in the case of a fast heart rhythm it will simply see that there are enough heartbeats and that it does not need to put any extra heartbeats in.
Implanting a cardiac pacemaker is a more minor procedure than most patients realise. It is done under local anaesthetic and sedation. A small incision is made in the skin just under the collarbone and a needle placed into a large vein in that region. It guide wire and then a plastic tube is then passed into the vein and through this to the pacing wire is fed down the veins and positioned in the heart. The pacing generator is then connected to the pacing wire slipped under the skin into a pocket and the original incision closed. The whole procedure is fairly minimally invasive. Many patients “wake up” after the procedure is over.
The patient can go home the next day. The DVLA require a week off driving.
Biventricular Cardiac Pacing
A biventricular pacemaker functions as a normal pacemaker but in addition coordinates the beating of the walls of the main pumping chamber–the left ventricle.
The implantation procedure is similar to that described above. The difference is that instead of two leads, there are three leads. The third lead needs to be introduced into the coronary sinus to pace the left ventricle. This can be difficult, and so the procedure usually takes longer.
A Biventricular Pacemaker can be very helpful in synchronising the beating of the walls of the main pumping chamber-the left ventricle. This can lead to a substantial improvement in cardiac function and the patient’s symptoms.