Why do I need a pacemaker? 

• Ventricular (ven-TRIK-u-ler) tachycardia (tak-ih-KAR-d-uh). This is an arrhythmia when your heart beats too fast.
  
• Cardiomyopathy (kar-d-o-mi-OP-uh-thee). This is when the heart has swollen up and cannot work properly.
  
• Dizziness, severe fatigue (tiredness), fainting (passing out), or confusion.
  
• Heart surgery.
  
• Slow heart rate.

What kinds of pacemakers are there?Pacemakers work when they need to or all of the time. There are 3 different kinds of pacemakers:

• Permanent: A permanent pacemaker is also called a long-term pacemaker. An incision (cut) is made in your neck or chest. The leads are guided through a vein into your heart, and attached to the generator. The generator is placed in a pocket under your skin. You will have this type of pacemaker forever.
  
• Transcutaneous (trans-q-TA-nee-us): This pacemaker is also called an external pacemaker. It is used in emergency situations when your heart is beating too slowly. When this happens, your caregiver needs to speed up your heart rate quickly. Small sticky patches are applied to your chest, and leads are attached to these patches. At the end of the leads is a pacemaker with dials on it. These dials allow your caregiver to immediately adjust the settings of the pacemaker. This type of pacemaker is used for a short time. After a time, you may need to get a permanent pacemaker, or you may not need a pacemaker anymore.
  
• Trasvenous (trans-V-nus): A transvenous pacemaker is also called a temporary pacemaker. The leads for the pacemaker are guided into your heart through an incision in your neck or chest. With a transvenous pacemaker, the generator is worn outside your body in a small pouch. You will carry this pouch with you everywhere.

How do I get a pacemaker? 

• You will need a procedure to get a pacemaker unless you have a transcutaneous (trans-q-TA-nee-us) pacemaker. The procedure will take about 1 to 2 hours. The procedure may be done while you are already a patient in the hospital. You may also come into the hospital in the morning and go home after your procedure. Your caregiver will make this decision.
  
• In some cases, you or your caregiver may want you to be completely asleep during the procedure. In most cases, you will be awake, but very drowsy. An anesthesiologist (an-iss-thee-z-ALL-o-jist) is a caregiver that gives medicine to make you sleepy and comfortable during your procedure.
  
• Your caregiver will give you intravenous (in-truh-V-nus) medicine to help you relax. An incision will be made in your neck or chest. With the help of a special x-ray, the leads of the pacemaker will be guided into your heart. The leads may also be hooked to the outside of your heart. A pocket is made under your skin, usually just below your collarbone. This pocket is where the generator is placed. The leads are connected to the generator, and the pacemaker is programmed especially for the needs of your heart.

What does it feel like?Once the pacemaker is in you, you will not feel it watching your heart. You will be able to see and feel the outline of the pacemaker through your skin.

Pacemakers and Pacemaker Telephone Analysis:

Once a pacemaker has been implanted, it needs to be analyzed several times a year.  Depending on different circumstances, the pacemaker needs to be analyzed by a Physician or Physician Assistant in the office at Hunterdon Cardiovasculare Associates once or twice yearly.  The patient needs to have the pacemaker checked over the telephone every month or every other month depending on the age of the pacemaker.

The telephone checks are to evaluate two basic parameters:

• The status of the battery
  
• The competence of the connections from the pacemaker to the heart

If a problem is found, the patient will be advised to come to the office for further evaluation.

Coping:You and your family may feel scared, confused, and anxious after the pacemaker procedure. You may be afraid that the pacemaker will not work. These feelings are common. Talk about them with your caregiver or with someone close to you. For more information, you may call or write:

• American Heart Association National Center
  7272 Greenville Avenue
  Dallas, TX75231-4596
  Phone: 1-800-242-8721
  Web Address: http://www.americanheart.org