Pacemaker Devices: Types and differences in usability

Cardiology | by Dr. Anil Mishra | Published on 30/05/2022

Introduction 

The term pacemaker is something that most of us are familiar with. Also referred to as a cardiac pacing device, it is a tiny device that is placed inside the chest of a patient to help their heart beat efficiently. It does this by stimulating the heart to beat at a normal pace by generating electrical impulses. A pacemaker essentially has two different parts - the pulse generator and the leads or electrodes. The former refers to a tiny metallic box, inside which the battery and electrical circuitry are present. The latter referred to insulated leads that carry the pulses generated by the generator to the heart. Nowadays, you can also find pacemakers that do not require a lead. Such pacemakers are referred to as leadless pacemakers.

In this blog, we will discuss pacemakers and their types with the guidance of experts specializing in pacemaker implantation and heart valve replacement surgery in Kolkata. 

You can book your appointment with one of the best cardiac hospitals in Kolkata at BM Birla Heart Hospital if you experience symptoms like chest pain, shortness of breath, dizziness, heart palpitations, or irregular heartbeat. 

What are pacemakers?

Pacemakers, commonly called cardiac pacing devices, are tiny electronic devices implanted in the chest to ensure improved regulation for conditions like abnormal heart rhythms. They function by sending electrical impulses to the heart muscle so that it can maintain a stable heartbeat. Pacemakers aid in ensuring that the heart is beating at a normal pace, mainly in cases where the heart's natural pacemaker is functioning inappropriately or in case of irregular heartbeats or arrhythmias. The latest pacemakers are refined devices that assist in monitoring heart rhythm and fixing the pacing rate. Pacemakers are intended with additional features such as wireless monitoring and remote programming efficiencies. All in all, pacemakers play an important role in managing the disorders of heart rhythm and enhancing the quality of life for patients having cardiac conditions.

How does a pacemaker work?

A pacemaker works by controlling the heart's electrical activity and providing electrical impulses to manage heart rhythm. A pacemaker usually involves two primary components: the pulse generator and the leads. The pulse generator is a small metal box implanted under the skin near the collarbone that has the battery and electronic circuitry for generating electrical impulses. On the other hand, the leads are insulated wires that help in delivering electrical signals from the pulse generator to the heart muscle. They are cabled through blood vessels into the heart chambers. When the heart's natural pacemaker is unable to maintain its regular heartbeat, the pacemaker has to interfere so that it can ensure a steady rhythm. Modern pacemakers are programmable and easily adaptable to different pacing rates depending on the person's body's requirements. This technology helps to manage various heart conditions and enhance overall heart function and quality of life.

What are the different types of pacemakers?

Heart specialists in Kolkata suggest that conditions like bradycardia can give rise to symptoms like syncope, angina, fatigue, palpitations, dizziness, and breathlessness. It can be a result of damage to any part of the heart and depending upon which chamber has been affected, different types of pacemakers are involved for the treatment purpose. Here are some of its types:

• Single-chamber pacemaker - The pacemaker has a single lead that connects the generator to any one of the chambers of the heart, i.e. either the right ventricle which is the lower right chamber of the heart, or the right atrium (upper right chamber of the heart). It is used when only a single chamber of the heart is affected. Single chamber pacemakers are recommended for patients with isolated sinus node disease without any indication of AV node disease. Ventricular single-lead pacemakers are used to stimulate normal heartbeats in patients with severe atrial fibrillation and minimal ventricular response.
• Dual-chamber pacemaker - As the name suggests, the pacemaker has not just 1 but 2 leads, that are inserted in both, the right atrium and the right ventricle. The device is so designed that it creates normal synchrony between the atrial and ventricular contractions. In such pacemakers, the lower rate is the rate at which the pacemaker will stimulate the atrium (in the absence of natural atrial activity), and the upper tracking limit is the pace at which the ventricle stimulates (in the presence of high atrial activity).
• Biventricular pacemaker - A biventricular pacemaker is similar to the conventional pacemaker, with the only difference being that it has a third wire that connects to the lower or upper left chamber to simulate their pacing. It is commonly referred to as a cardiac resynchronization therapy (CRT) device. The procedure is commonly recommended for people who have arrhythmia developed after advanced heart failure. It is quite possible that the two ventricles of the heart may not pump at the same rate after a heart failure and this is where the biventricular pacemaker comes in handy. It coordinates the pacing of both chambers.

Why is pacemaker implantation recommended?

The treatment is widely recommended for patients with bradycardia, a condition marked by a slow heartbeat, less than 60 beats per minute. This usually happens after a heart attack, or if you undergo a major heart procedure. In some cases, it can also be a result of an overdose of certain medicines, damage to the heart muscles owing to a traumatic injury, age-related wear, and tear, or a heart problem that has been there since birth. Apart from all these, several medical conditions call for the need for pacing, with the primary indications being sinus node dysfunction and ventricular blockage.

What are the differences in pacemaker usability?

• Programming Capabilities: Modern pacemakers are programmable permitting healthcare experts to adapt to their pacing settings remotely which makes meeting the requirement of a patient's needs easier without regular in-person visits.
• Wireless Monitoring: Some pacemakers are designed with wireless monitoring capabilities, allowing health experts to remotely control the device's functionality and the patient's heart health, delivering timely interference in case of an emergency.
• Leadless Pacemakers: Unlike conventional pacemakers that require leads, leadless pacemakers are tiny and self-contained devices implanted into the chamber directly. They are also known as minimally invasive alternatives for some patients and minimize the risk of complications linked to leads.

Conclusion

Pacemaker devices have renewed heart rhythm disorders management by delivering tailored solutions and fulfilling the unique needs of patients. Comprehending the types of pacemakers and their differences in usability is important for both healthcare experts and patients. With recent developments in technology, pacemakers continue to advance, offering secure, more efficient, and patient-centric solutions for cardiac care. Pacemakers will without a doubt remain unwavering guardians of heart health, ensuring that every heartbeat counts.

To know more about pacemakers and how these can help you, you can consult the experts from the best heart hospital in Kolkata.

Faq -

Why is a pacemaker used?

A pacemaker is used for the treatment of abnormal heart rhythms causing the heart to beat either very slow or very fast or miss beats. It assists the chambers in the heart to be in sync with the heartbeats. 

How to avoid getting a pacemaker?

To avoid getting a pacemaker, it is vital to follow a healthy lifestyle, regularly exercising, eating a well-balanced diet, and quitting smoking, and alcohol consumption. You must also ensure the monitoring and management of conditions like high blood pressure, diabetes, etc. 

How long does a pacemaker last? 

Depending on the use, pacemakers usually last five to seven years, after that they require batter or pulse generator replacement.