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Pacemaker-The device that sparks up the heart beat

The heart has its own electrical system. The coordinated action of heart beat occurs because the heart is "wired" to send electrical signals that signal the chambers of the heart when to contract. The electrical outlet of the heart or the natural pacemaker is located in the atrium or the upper chamber of the heart. It acts like a spark plug that fire in a regular, rhythmic pattern to regulate the heart's rhythm. This "spark plug" is called the sinoatrial (SA), or sinus node. It sends signals to the rest of the heart so the muscles will contract.

In a normal heart, this coordinated series of electrical signals occurs about once every second, maintaining the steady, rhythmic pattern of the heart’s beat. In case the heart beat is too slow (bradycardia), or too fast (tachycardia), an artificial pacemaker insertion is carried out to help restore normal rhythm.

A pacemaker is an electrically-charged medical device that has two parts. One part contains the battery and the electronics that control the heartbeat and the other part has one or more leads that send electrical signals to the heart. Leads are small wires that connect the pulse generator to your heart muscle. There are biventricular pacemakers or bivents that are utilized in case of a severe heart failure. They make both the sides of the heart beat in synchronization. It is also called cardiac resynchronization therapy (CRT). There are temporary pacemakers that are used for a short duration, immediately after a heart attack or a heart surgery or if a drug overdose has temporarily caused bradycardia.

The pacemaker procedure or implantation will take not more than 2 hours. The patient will be sedated and given a local anaesthesia at the incision site. An incision is made near the shoulder and a wire is guided into a major vein near the collar bone up to the heart. An electrode is attached to the right ventricle. The other end of the wire is attached to a pulse generator which contains the battery and electrical circuits that is typically implanted under the skin near the collarbone.

The implant is regularly monitored and maintained by cardiology. The patient should be aware that certain devices could cause interference with the pacemaker and such exposures should be avoided. The avoid list for patients with the implants include carrying a cell phone or MP3 player in the pocket over the implant; long exposures to microwaves, metal detectors or high voltage transformers etc.

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