People need a pacemaker when their heart beats too slowly or irregularly to supply enough blood to the body.
Why
A pacemaker is a device that sends electrical impulses to the heart.
Conditions
- Bradycardia (slow heart rate).
- Heart block.
- Sick sinus syndrome.
- Some heart failure cases (cardiac resynchronization).
How it works
A small device under the skin and wires to the heart sense rhythm and send pulses when needed.
Facts
About 1 million are implanted worldwide each year. Batteries last 5 to 15 years.
Safety
Avoid strong magnets.
Heart rhythm problems
A pacemaker is a small device implanted under the skin near the collarbone that sends electrical pulses to the heart through leads to keep a steady rhythm. The heart’s natural pacemaker, the sinoatrial (SA) node, can fail.
Conditions
- Bradycardia, a heart rate that is too slow (below 60 beats per minute) with symptoms such as fatigue, dizziness or fainting.
- Sick sinus syndrome.
- Heart block (atrioventricular block), where signals from the atria do not reach the ventricles properly.
- Atrial fibrillation with slow ventricular rates after treatment.
- Heart failure with certain conduction delays (cardiac resynchronization therapy).
- Fainting (syncope) due to rhythm problems.
Statistics
Over 1 million pacemakers are implanted worldwide each year, and about 3 million people in the US live with one. Most recipients are over 65.
How it works
Sensors detect the heart’s own activity. If the heart beats too slowly or pauses, the device sends a pulse. Modern pacemakers adjust rate with activity. Batteries last 5 to 15 years and are replaced in a minor procedure.
Types
Single chamber, dual chamber, biventricular and leadless pacemakers (the Micra device is about the size of a vitamin capsule and sits inside the heart).
History
The first implantable pacemaker was placed in Sweden in 1958 by Rune Elmqvist and Ake Senning for Arne Larsson, who lived to age 86 and used 26 pacemakers.
Safety
Cell phones are safe if kept 6 inches from the device. Avoid strong magnets and MRI unless the device is MRI conditional. Airport security wands are generally safe if brief.
Risks
Infection, bleeding and lead problems are uncommon.
Follow up
Check-ups every 3 to 12 months, with remote monitoring.
Who gets pacemakers
A pacemaker is a small device implanted under the skin near the collarbone that sends electrical pulses to keep the heart beating at a safe rate. Common reasons are bradycardia (slow heartbeat), heart block and sick sinus syndrome. More than 1 million pacemakers are implanted worldwide each year, according to the American Heart Association, and around 200,000 are placed in the US annually, mostly in people over 65.
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Device details
Modern pacemakers weigh about 20 to 30 grams, with batteries lasting roughly 7 to 15 years. Leadless pacemakers such as the Micra are implanted inside the heart through a catheter. Most devices are safe with ordinary electronics, but strong magnets and MRI need specific compatibility checks. Patients have regular checkups, often with remote monitoring.
Based on data from the American Heart Association and the Heart Rhythm Society
