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Pacemakers: Electric signals for a regular rhythm

A pacemaker is an implanted medical device developed for patients whose hearts beat too slowly, a condition called bradycardia. The implant monitors the patient’s cardiac activity and transmits electrical signals when it does not detect a natural heart rhythm. These signals cause the heart muscle to contract. In this way, the pacemaker makes sure that the heartbeat is regular and faster.

The device itself is composed of a miniaturized electronic circuit and a compact battery. One or two leads connect the device to the heart. A lead is a very thin, electrically insulated wire that is anchored in either the right atrium or the right ventricle of the heart. The lead transmits the electrical signal to the heart, detects cardiac activity and relays this information to the pacemaker.

Single-chamber pacemakers

Pacing systems are divided into single-chamber and dual-chamber systems. Single-chamber systems have a single lead connected into one of the chambers of the heart. This is most commonly the right ventricle and occasionally the right atrium. Cases where this is chosen include atrial fibrillation or sinus node dysfunction.

Dual-chamber pacemaker

Dual-chamber pacemakers are connected to the heart by two thin leads, with one in the atrium and one in the ventricle (see figure). This allows them to monitor both the atrium and the ventricle—and to pace them as required. This allows a more physiological response where pacing can occur in either the atrium or the ventricle.

Longevity of a pacemaker

A pacemaker for pacing the heart is powered by a battery. Like all batteries, this battery eventually becomes depleted, at which time your pacemaker will be replaced. It is impossible to predict exactly when this will happen. It depends first and foremost on how often your pacemaker is activated. In general, though, a pacemaker lasts for many years—at least eight and often longer.

Regular follow-up appointments with your physician ensure that your pacemaker will be replaced before the battery becomes too weak. The programmer will notify your physician of the depleting battery months in advance. Pacemakers with the BIOTRONIK Home Monitoring® function also keep the physician constantly informed of the current battery status. It notifies the physician as soon as the battery begins to be depleted.

Sensors for stress detection

Many pacemakers use a sensor to automatically adapt the signal transmission rate to the patient’s physical activity. The sensor reacts to various physical stress levels when a patient runs, swims or works—and prompts the pacemaker to start pacing at an increased heart rate.

The newest generation of BIOTRONIK pacemakers can also respond to emotional stress, such as when you are watching a thrilling movie or when something unexpected happens and your heart rate accelerates and blood pressure increases.



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