1ST CITY CLINICAL HOSPITAL

A pacemaker  is an electronic device that is implanted to regulate the heart rhythm. It consists of a battery and an electronic circuit (minicomputer) enclosed in a sealed titanium case. Its size is quite small (volume less than 13 cm3, and weight about 25 grams). Placed under the skin near your heart.

People may need a pacemaker for a number of reasons that cause their heart rhythm to become irregular.

• Normal aging of the heart can disrupt your heart rhythm, causing it to beat too slowly.
• Trauma to the heart muscle.
• Some medications that affect heart rhythm.
• Hereditary diseases.
• Past infectious diseases

Regardless of the root cause of the abnormal heart rhythm, a pacemaker will help you restore full heart function.

Why do they do this?

Pacemakers are implanted to help control your heartbeat. They may be placed temporarily to control a slow heartbeat after a heart attack, surgery, or drug overdose. Pacemakers may also be implanted permanently to correct a slow heartbeat (bradycardia) or, in some cases, to help treat heart failure.

How does your heart beat?

The heart is a muscular pump with four fist-sized chambers, two on the left side and two on the right. The upper chambers are the right and left atria. The lower chambers are the right and left ventricles. For your heart to function properly, the chambers must work in a coordinated manner. Your heart should also beat at the appropriate rhythm - usually between 60 and 80 beats per minute. If your heart beats too slowly, it can lead to fatigue, fainting, shortness of breath and other complaints. A normal heartbeat begins in your right atrium at the sinus node. This group of cells - your natural pacemaker - acts like the spark plug in a car engine, regularly generating electrical impulses that pass through specialized muscle fibers and cause the chambers of the heart to contract consistently, sending blood to the organs and tissues.

What does a pacemaker do?

The integrated electronic pacemaker imitates the action of your natural pacemaker.

The pacemaker itself consists of two parts:

• Pulse generator. This small metal container contains a battery and an electrical circuit that regulates the level of electrical impulse sent to your heart.
• Leads (electrodes). One-third of the flexible, insulated wires, each placed in a chamber or chambers, of your heart deliver an electrical impulse to regulate your heart rate.

Pacemakers  monitor your heartbeat and if it is too slow, the pacemaker will speed up your heart rate by sending electrical signals to your heart. In addition, most pacemakers have sensors that sense body movement or breathing rate, which signals the pacemaker to increase your heart rate during exercise, helping to meet your body's increased demands for blood and oxygen.

The choice of pacemaker is determined by the pathology of the cardiac conduction system, i.e. Depending on the diagnosis, either a two- or a single-chamber pacemaker may be optimal. The decision on the type of implantable pacemaker is made by the x-ray endovascular surgeon after examining the patient and studying the medical documentation.

The operation is performed under x-ray control. Pacemaker leads are implanted in the right atrium and right ventricle (dual-chamber pacemaker) or in the right ventricle (single-chamber pacemaker). The pacemaker itself is placed under the skin or under the pectoralis major muscle, usually under the left collarbone. After installation, the tissues are sutured in layers, and sutures are placed on the skin.

A modern pacemaker is a complex minicomputer that constantly monitors the work of the heart, analyzes its contractions and, if necessary, supplies the heart with stimuli, thereby ensuring the most correct and physiological contraction of the heart. The pacemaker collects data on the work of the heart over a long period of time (months and even years) and, in accordance with the collected data, its work is adjusted. Based on these data, the optimal pacemaker settings are set and the appropriate drug therapy is selected that is best suited for your body. This is done using a special device - a programmer-analyzer, which is a computer similar to a laptop. To do this, you just need to attach a special device to the stimulator - under the left (right) collarbone.