Has your cardiologist recommended that you have a pacemaker implanted to help regulate your heartbeat? If so, you are among the nearly 200,000 people who have this procedure each year in the United States.

Why do I need a pacemaker?

Your doctor may suggest a temporary pacemaker when you have a slow heartbeat (also known as bradycardia) after a heart attack or surgery, or a pacemaker may be implanted permanently to correct an irregular heartbeat or to help treat heart failure.

What exactly is a pacemaker and how does it work?

A pacemaker is a small battery-operated device that helps the heart beat in a regular pattern. It is designed to only work when needed and replaces the heart’s natural pacemaker functions, controlled by a part of the heart known as the sinoatrial node. If your heart beats too slowly, the pacemaker sends electrical signals to correct the rhythm.

There are single chamber and dual chamber pacemakers.

A single chamber pacemaker carries electrical impulses to the right ventricle of your heart, while a dual chamber pacemaker carries electrical impulses to the right ventricle and right atrium to help control the timing of contractions between the two chambers.

There are two main components to the pacemaker: the pulse generator and wires, or leads.

The generator produces electrical impulses that stimulate your heart to beat and is typically implanted under your skin through a small incision near the collarbone. The generator is connected to your heart through tiny wires that are implanted at the same time.

The electrical impulses flow through the wires to your heart and are timed to flow at regular intervals just as impulses from your heart's natural pacemaker would.

Some newer pacemakers don't require leads. These devices, called leadless pacemakers, are implanted directly into the heart muscle.

Most pacemakers have a sensing mode that inhibits the pacemaker from sending impulses when the heartbeat is above a certain level. It allows the pacemaker to fire when the heartbeat is too slow.

It is important to understand how your pacemaker works. The device has a programmed lower and upper heart rate. Talk to your doctor about the maximum acceptable heart rate above your pacemaker rate.

What happens after a pacemaker is implanted?

The American Heart Association recommends allowing eight weeks for your pacemaker to settle in place. Modern pacemakers are built to last, but your pacemaker should be checked periodically to assess the battery and how the wires are working. 

Your doctor may recommend that you take and record your pulse often to gauge your heart rate. This allows both of you to compare your heart rate to your acceptable range to determine if your pacemaker is working effectively.

Tips for living with a pacemaker:

• Be physically active. Try to do what you enjoy – or what you feel up to – each day. Take a short walk, or simply move your arms and legs to aid blood circulation.
• Don’t overdo it. Quit before you get tired. The right amount of activity should make you feel better, not worse.
• Feel free to take baths and showers. Your pacemaker is completely protected against contact with water.
• Car, train or airplane trips should pose no danger.
• Stay away from magnets and strong electrical fields.
• Tell your other doctors, dentists, nurses, medical technicians and hospital staff members that you have a pacemaker.
• Remember your pacemaker when you arrive at the airport or other public places with security screenings. Metal detectors won't damage your pacemaker, but they may detect the metal in your device. At the airport, let a screening agent know that you have a pacemaker.