A pacemaker is a small device implanted in the chest to help control abnormal heart rhythms, or arrhythmias. The device helps patients maintain a normal heart beat by sending regular electrical pulses to stimulate the heart. Arrhythmias can interfere with the flow of blood to the body, causing fatigue, shortness of breath and, in severe cases, loss of life. A pacemaker is composed of a battery, a pulse generator, and wires (called leads) with sensors at their tips. Pacemakers may send electrical pulses only when the heart is beating too slowly or misses a beat (demand pacing) or may speed up or slow down the heart rate depending on the patient's activity level (rate-responsive pacing).
Pacemaker surgery requires a small incision just below the collarbone. The pacemaker's leads are threaded into the heart through a large vein under the collarbone. The physician uses a type of x-ray called fluoroscopy to position the leads and then attaches them inside the heart muscle by either a small corkscrew (active fixation) or a tined tip (passive fixation). Once the pacemaker's leads are positioned and plugged in, the pulse generator is placed into a pocket under the skin and is sutured over.
In addition to pacemaker surgery, other treatments for abnormal heartbeat depend on the type of arrhythmia and may include:
Medications to help control heart rhythm
Cardioversion, which uses large electrodes to send an electrical current to the heart muscle to restore its normal rhythm
Cardiac ablation, a procedure that involves guiding a catheter through the blood vessels into the heart and destroying tissue in the area of the heart causing fibrillation
An implantable cardioverter-defibrillator (ICD), a device implanted in the chest similar to a pacemaker that is used to treat rapid heartbeat in ventricular tachycardia treatment
For the latest in pacemaker surgery and atrial fibrillation treatment, patients in the Boston area can find state-of-the-art treatment at the Shapiro Cardiovascular Center at Brigham and Women's Hospital.
The latest in cardiac care, including pacemaker surgery
The Shapiro Cardiovascular Center at Brigham and Women's Hospital provides innovative and comprehensive care for patients requiring complex coronary disease treatment and vascular disease treatment. A robust research program enables physicians to provide patients with the very latest in prevention, diagnosis and treatment for a wide variety of cardiovascular conditions, including pacemaker surgery. The Cardiac Arrhythmia Service at the Shapiro Cardiovascular Center is devoted solely to the care of patients with irregular heart rhythms, heart palpitations and rapid heartbeat conditions.
In addition to treatment for arrhythmias, including pacemaker surgery, the Shapiro Cardiovascular Center provides state-of-the art care for patients with all types of cardiovascular conditions, including treatment of advanced heart conditions. For example, our expert cardiac surgeons can implant a ventricular assist device to help the heart pump in patients waiting for a heart transplant.