What is a pacemaker implant?

A pacemaker implant is the surgical placement of a device called an artificial pacemaker. It is a treatment for arrhythmias (abnormal heartbeats). Arrhythmias happen when your heart’s electrical signal causes it to pump too slowly, too quickly, or irregularly. A pacemaker implant uses electrical pulses to help your heart return to a normal heartbeat.

Your heart is basically a pump made up of muscle tissue. It has four chambers, two upper chambers (atria) and two lower chambers (ventricles). Like all pumps, your heart requires a source of energy in order to function. Your heart's pumping energy comes from a built-in electrical conduction system.

In order for you to have a normal heartbeat, your heart's four chambers must work in harmony with one another. A heartbeat is produced when an electrical signal travels through these chambers. Any malfunction in this signal can make your heart beat too quickly, too slowly, or at an uneven rate. This causes an arrhythmia.

A pacemaker implant has risks and potential complications. It is only one method used to treat arrhythmias. Discuss all of your treatment options with your doctor to understand which options are right for you.

Types of pacemaker implants

A pacemaker has two main parts. The first part is the wires with electrodes that connect to your heart. These wires continually monitor your heart rhythm. They send the information to the second part of a pacemaker, the pulse generator. The pulse generator is a small battery-operated computer. It recognizes abnormal heart rhythms and responds by sending electrical pulses back to your heart to correct the rhythm. 

The types of pacemaker implants include:

  • A biventricular pacemaker has three wires that connect to the right upper chamber (right atrium), the right lower chamber (right ventricle), and the left lower chamber (left ventricle). It coordinates signals between the right atrium and both ventricles. This type of pacemaker is also called a cardiac resynchronization therapy (CRT) device.
  • A dual chamber pacemaker has two wires that connect to an upper chamber and a lower chamber of your heart. It corrects abnormal electrical signals between the two chambers.
  • An external pacemaker stays on the outside of your body to adjust your heart rate and rhythm. It is for temporary or emergency use, such as immediately after a heart attack.
  • A single chamber pacemaker has one wire that connects to either an upper chamber or a lower chamber. It corrects abnormal electrical signals within a chamber. 

Types of pacemaker programming

Your doctor can program your pacemaker implant computer from outside your body. 

The types of pacemaker programming include:

  • Demand programming monitors your heart rhythm and only sends pulses when it detects an abnormal heart rate or your heart misses a beat.
  • Rate-responsive programming also monitors your breathing, body temperature, and other factors. It uses this information to determine your activity level. It then adjusts itself either up or down to match your activity level.

Why is a pacemaker implant performed? 

Your doctor may recommend a pacemaker implant to treat a heart arrhythmia. Your doctor may only consider a pacemaker implant for you if other treatment options with less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a pacemaker implant. 

Your doctor may recommend a pacemaker implant to treat:

  • Congenital (present at birth) heart disorders, meaning they are present at birth
  • Heart block, a blockage in your heart’s electrical pathway
  • Heart failure, a condition in which the heart cannot pump enough blood to the body
  • Heart transplant
  • Hypertrophic cardiomyopathy, a complex heart disease characterized by thickened heart muscle and ventricular stiffness
  • Irregular heart beat or skipped heartbeats that occur often 
  • Syncope, unexplained fainting 
  • Too rapid or too slow heart beats, called tachycardia (too rapid) and bradycardia (too slow), that happen too often or at abnormal times