Pacemaker implantation is a surgical procedure in which a device is implanted into the patient’s body to regulate heart rhythm. A pacemaker is used to treat arrhythmias—disorders of heart rhythm such as abnormally slow heart rate (bradycardia) or irregular rhythm. The device delivers electrical impulses to the heart muscle, helping to maintain a stable and adequate heart rate.
When is pacemaker implantation required?
A pacemaker is indicated for patients with cardiac rhythm disorders that may be life-threatening or significantly impair quality of life.
Main indications
- Bradycardia. An excessively slow heart rate causing fatigue, dizziness, or syncope.
- Sick sinus syndrome. Dysfunction of the heart’s natural pacemaker.
- Atrioventricular (AV) block. Impaired conduction of electrical impulses between the atria and ventricles.
- Heart failure. In selected cases, pacing therapy improves coordination of cardiac chamber contractions.
Types of pacemakers
- Single-chamber pacemaker. Delivers impulses to one heart chamber, usually the right ventricle.
- Dual-chamber pacemaker. Coordinates atrial and ventricular activity, improving atrioventricular synchrony.
- Biventricular pacemaker (cardiac resynchronization therapy, CRT). Used in patients with heart failure to synchronize left and right ventricular contractions.
How is pacemaker implantation performed?
Preoperative preparation
The patient undergoes a comprehensive evaluation, including:
- Electrocardiography (ECG).
- Echocardiography to assess cardiac function.
- Chest X-ray.
- Blood tests.
Implantation procedure
- Anesthesia. The procedure is performed under local anesthesia, sometimes with mild sedation.
- Lead placement. Through a small incision below the clavicle, pacing leads are introduced into a large vein and guided to the heart under fluoroscopic control. The leads are fixed in the appropriate cardiac chambers (atrium, ventricle, or both).
- Generator implantation. The pulse generator, approximately the size of a coin, is implanted subcutaneously in the chest area.
- Device programming. After implantation, the pacemaker is programmed to ensure optimal pacing parameters.
The procedure typically lasts 1–2 hours.
Postoperative period
- The patient remains in hospital for 1–2 days for monitoring of heart rhythm and the implantation site.
- Strenuous physical activity should be avoided for 4–6 weeks. Pressure on the implantation area (for example, from straps or bags) should be avoided.
- Medications may be prescribed to control heart rhythm or prevent inflammation.
- The first follow-up examination is usually scheduled a few weeks after implantation. Thereafter, device checks are performed every 6–12 months.
Outcomes of the procedure
- Device longevity. Pacemaker batteries typically last 5–15 years, after which replacement is required.
- Improved quality of life. Most patients experience significant relief of symptoms such as fatigue, dizziness, and syncope.
- Regular follow-up. Ongoing cardiology visits are essential to monitor device function and overall cardiac health.
Pacemaker implantation in Belarus is an effective and well-established procedure that helps patients with serious cardiac rhythm disorders improve quality of life and prevent complications. Modern pacemakers are highly reliable and significantly improve patient survival. Regular follow-up with a cardiologist and adherence to medical recommendations are essential for long-term device performance and patient health.
Q&A
Yes, but it is recommended to keep the phone at least 15 cm away from the pacemaker and avoid carrying the phone in a chest pocket.
Avoid strong magnetic fields (e.g., industrial magnets, some medical devices such as MRI).
If you suspect a malfunction of your pacemaker, consult a doctor immediately.
