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Pacemaker surgery: Fixing low heart rate or bradycardia

A pacemaker is a device implanted during surgery, which “delivers electrical impulses to the heart to stimulate its rate from going too slow, which is often referred to as bradycardia,” said Dr. Weijia Wang, a board-certified cardiologist specializing in cardiac electrophysiology with Marshfield Clinic Health System.

Man and woman walking through the woods considering pacemaker surgery
Advancements in pacemaker technology mean Marshfield Clinic Health System doctors can monitor your heart health even when you’re at home.

Furthermore, advancements in medical technology are making long relied on pacemakers even more effective in protecting overall heart health. 

Who needs a pacemaker?

Patients with an abnormally slow heartbeat, or bradycardia, that is causing symptoms are candidates to receive the device.

Some people requiring a pacemaker may simply have an issue with a slow heartbeat, but commonly the need for a pacemaker is accompanied by other heart health issues, Dr. Wang said.

“If the heartbeat is not there, the pacemaker delivers a heartbeat timed in a way that mimics how the heart would normally work,” he said.

Symptoms of an abnormally slow heartbeat may include:

  • Shortness of breath
  • Lightheadedness
  • Feeling faint
  • Feeling skipped or irregular heart beat
  • Abnormal fatigue

”But all those symptoms could be caused by a variety of other issues,” Dr. Wang said.  “So the best course of action is to first consult with your primary care doctor.”

Pacemaker surgery

A pacemaker is implanted during a surgery while patients are inside a special X-ray room and under sedation, Dr. Wang said.

Local anesthetic just below the collarbone, where the pacemaker will be positioned, is used to numb the skin. Afterward, wires are then threaded through a vein to the heart and subsequently hooked to the pacemaker, which allows it to detect the patient’s heartbeat. Most patients can go home the same day.

For selected patients, leadless or wireless pacemakers can be a good option. It eliminates the scar on the chest, the possibilities of damaging the lungs and vessels, wires breaking, and device infection.

As a result, we offer both traditional and leadless pacemakers at Marshfield Clinic Health System.

Advancements in pacemakers

Major improvements in pacemakers over time include the ability for doctors to remotely monitor the device’s performance.

“Typically, people with pacemakers have a monitor in their homes, which collects information from the pacemaker that can then be sent to their providers, notifying us of problems we previously would not have known about,” Dr. Wang said.

Today’s pacemakers can inform doctors of other issues, like atrial fibrillation, the rapid beating of the heart’s upper chambers.

“We now offer physiologic pacing, in which the pacing lead is placed close to the native conducting cells in the heart to simulate the normal conduction of the heart,” he said. “It has been shown to prevent and treat heart failure.”

Does having a pacemaker impact your lifestyle?

“Most of the time, there’s not a big change in lifestyle required once a pacemaker is implanted,” Dr. Wang said. “The pacemaker is supposed to make people live longer and feel better.”

Exercising is fine with a pacemaker. However, he noted it’s important to protect the area where it is implanted from trauma. Contact sports are discouraged.

Additionally, while it’s OK to use a cellphone when you have a pacemaker, Dr. Wang said it’s best to keep the phone from being in close proximity to the pacemaker, like in a shirt pocket.

For questions on pacemakers, talk to a Marshfield Clinic Health System provider.

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