Basic Facts

More than 500,000 people in India currently rely on pacemakers to correct a slow, irregular, or otherwise abnormal heartbeat. Pacemakers can be temporary or permanent, external or internal. Temporary external pacemakers are usually reserved for patients who have a transient heart malfunction or require major surgery that could interfere with the normal heartbeat. Internal pacemakers are used for chronic conditions that cause persistent or intermittent slowing of the heart rate. Pacemaker insertion often is a straightforward, outpatient procedure, and complications occur in only 1 to 2 percent of insertions. Once the pacemaker is fully adjusted, the patient should be able to carry out all the functions of normal daily life, with the pacemaker automatically adapting to various circulation and heartbeat needs.

If heart muscle cells are damaged such that electrical rhythms to the heart are interrupted, delayed, or sent down the wrong path, the heartbeat may become irregular, too fast, or too slow. The patient may require a pacemaker, a device to restore a normal heartbeat. Most pacemakers are installed to counteract problems with either failure of cardiac impulse formation or failure of the atrioventricular node (A-V node) conduction.

WHEN IS THE PROCEDURE INDICATED?
A pacemaker may be indicated in the following situations:

• People with temporary, intermittent, or persistent conditions that interfere with their heart's ability to initiate or properly distribute electrical signals;
• People with congenital, as well as acquired, heart problems that result in bradycardia (a slow heartbeat, fewer than 60 beats per minute) or an otherwise uneven heartbeat (tachyarrhythmia);
• People receiving drug therapy for other heart conditions, such as beta-blockers, to prevent related bradycardia; and
• People with recurrent syncope (fainting).

Some viral infections can damage the heart such that a pacemaker needs to be inserted.

PRE-TREATMENT GUIDELINES
The patient needs little preparation other than to communicate how he or she is feeling on the day of the operation and inform the physician about all medications taken within the past month. In most cases, patients are advised to avoid eating 12 hours prior to the surgery.

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