Permanent pacemakers (PPM) are devices that are implanted on the inside of the heart in order to increase the patient’s heart rate and, in some cases, even treat or prevent heart failure. PPMs are a treatment option for patients who have a type of arrhythmia know as bradycardia, which is a slow heart rate.
The goal of a PPM is to improve the patient’s symptoms, which may include lethargy, fatigue, shortness of breath, lightheadedness and even fainting. Patients with these symptoms are often monitored for several days to prove the heart rate is slow. However, just because a patient’s heart rate is low does not mean a pacemaker is necessary or appropriate.
Pacemaker implantation is a minimally invasive procedure. Standard pacemakers have between one and three leads and a generator/battery. The leads are inserted into the heart through a vein under the collarbone and then attached to the generator/battery. The unit is placed under the skin below the collarbone. The skin is closed using sutures and surgical glue. The procedure is usually performed with light to moderate anesthesia.
After the procedure, the patient may have some soreness in the area where the device was inserted. It’s important to follow your physician’s instruction about keeping the wound clean and dry and avoiding inappropriate arm movement. Generally, patients can go home the day of the procedure and will be seen in an outpatient clinic about a week later.
Most devices will last between six and 12 years. When the battery runs low, the generator will be replaced. Generally, the leads will not be changed unless another lead is needed or an existing lead is not functioning correctly.
In a leadless pacemaker, the lead and the pacer are condensed into one very small device that is inserted through a large vein in the groin. This technology is new but has been approved by the FDA for use in the United States. The device can only correct issues with the lower right chamber of the heart, which means qualified patients are limited. The battery on the device lasts for about 10 to 12 years.