Pacemakers: What You Need to Know About Function and Life with Them

A pacemaker is a widely used medical device. Approximately 3 million patients worldwide live with a pacemaker, and around 600,000 implantations are performed each year.

Pacemaker technology has evolved significantly over the past 60 years. Modern devices allow patients to live with minimal restrictions, and some patients even complete marathons.

The pacemaker senses the electrical activity of the heart and provides electrical stimulation when needed, managing the heart rate to prevent bradycardia. It consists of a box placed subcutaneously in the chest, containing a small computer, a battery (lasting 8-10 years), and connectors for the leads. The leads are inserted into the atrium and ventricle of the heart through the central veins.

The main use of a pacemaker is to treat pathological bradycardias, which are diagnosed by a cardiologist with an ECG and clinical examination. Symptoms of bradycardia include fainting, easy fatigue, and shortness of breath. The most common diagnoses are atrioventricular block and sick sinus syndrome.

Pacemaker implantation procedures are performed in the cardiac catheterization laboratory under local anesthesia and fluoroscopic guidance. After the procedure, the patient stays in the hospital overnight. Postoperatively, there are restrictions for 4 weeks regarding the use of the left arm and driving.

With technological advancements, the quality of life for patients has improved. The use of electronic devices and exercise is permitted. In recent years, wireless pacemakers and subcutaneous defibrillators have been developed, offering additional options for patients.