An artificial pacemaker is a pacemaker that is used to stimulate the heart rhythm electrically. Implantation of such a pacemaker is performed under local anesthesia under X-ray guidance. Its operation is based on permanent or temporary stimulation, during operation it initiates an electrical activity. Implantation of such a device is used in patients with symptomatic, transient bradyarrhythmia (40–50 beats per minute or the presence of 4–5 s pauses) and often in people who are at risk of its occurrence.
Pacemaker implantation can be percutaneous, transesophageal, or intracardiac, most commonly below the left clavicle. The electrode or electrodes are inserted through the veins, and then into the heart, into the right ventricle, and, if necessary, additionally into the right atrium.
A four-letter code has been adopted for various types of applied stimulation, which is entered into the stimulator book, with which the patient reports for check-ups. The first such examination takes place about 2 months after the procedure, and the next ones should take place at least once a year.
Before the procedure, anticoagulants and antiplatelet drugs should be discontinued, which is very important due to the fact that an artificial device is permanently implanted, and at the same time prophylactic antibiotic therapy should be started and the skin in the area of surgery should be properly prepared.
After implantation of the artificial pacemaker, the patient stays in the hospital for another 24 hours, during which time the pacemaker’s operation is checked, a control X-ray of the chest is taken and all the patient’s vital parameters are monitored prophylactically.
The sutures are removed after about 10 days, and the operation of the battery used in artificial pacemakers is estimated for a period of several to even 10-12 years. After this time, it must be replaced.
Of course, complications are possible, including hematoma, venous thrombosis, pneumothorax or hematoma, subcutaneous pneumothorax, or infection. However, these are quite rare occurrences.
Among the indications for pacemaker implantation there are diseases of the conduction system of the heart, which by their nature can lead to life-threatening arrhythmias. Other diseases that fall under the treatment method of artificial electrostimulation include sick sinus syndrome, atrial fibrillation with slow heart rate, syncope, as well as other indications such as congestive heart failure or cardiomyopathy with narrowing of the outflow of blood from the left ventricle.
Above all, however, it should be remembered that the decision to pacemaker implantation taken by a specialist after the initial examination.
There are also contraindications to the implantation of the device, and this is a local or generalized infection, disorders of automatism. The most important thing, however, is that a pacemaker can save lives.