Pacemaker Devices: Types and differences in usability

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

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.

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, there are several medical conditions that call for the need for pacing, with the primary indications being sinus node dysfunction and ventricular blockage.

Heart specialists in Kolkata suggest that Bradycardia if left untreated 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 needed. We have discussed these in this blog, with the help of the experts specializing in pacemaker implantation and heart valve replacement surgery in Kolkata.

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, which is the 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 absence of natural atrial activity), and the upper tracking limit is the pace at which the ventricle stimulates (in 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 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.

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