Every heart has a “natural pacemaker”. This natural
pacemaker consists of small areas of the heart that keep the heart beating
regularly by stimulating the electrical current which makes the heart
contract (beat). When this natural pacemaker is not functioning properly,
the heart will not beat as it should and can beat at a dangerously low or
fast rate. Depending on the severity of this irregular heartbeat, your
physician may decide that you need an Implantable Pacemaker and/or ICD.
This is a small electronic device that is designed to “watch” the heart to
make sure it doesn’t beat too slow or fast. When the heartbeat is too slow,
the pacemaker will produce a small electrical impulse which causes the heart
to contract (beat) at a higher rate. When the heartbeat becomes dangerously
fast, the ICD will deliver an electrical shock to the heart which should
cause the heartbeat to slow down to a more normal rate.
Pacemakers/ICDs implantation is an outpatient procedure done
in the Electrophysiology lab in the hospital. The patient is given a
sedative, but is awake for the procedure. A small incision is made in a
large vein (usually the subclavian vein which is a large vein just under
your collarbone), and the leads that produce that current are put in the
chambers of the heart. They are tested to make sure they are in the correct
spot for that electrical impulse to work. Once these leads are correctly
placed, the physician will put in the generator, which is the part of the
device that “watches” your heartbeat and delivers the electrical impulse
when needed. This device is a little smaller than a deck of cards and is
placed in a “pocket” made just under the collarbone under the skin.
