A pacemaker is a man-made device that controls the heart beats when the heart fails to beat normally. It is a battery-operated device, about the size of a matchbox and is placed near the collarbone by a minor operation. It generates electrical impulses and sends them to heart through tiny wires. The ends of the wires are attached to the heart muscle. The wire can also sense the heart beating normally or abnormally and thus gives signal to the pacemaker when to start working.

There are many different types of pacemakers to suit various needs. Some may only help the heart beat when it gets too slow. Other pacemakers make the heart beat at all times. Special pacemakers can be used to deliver a shock to the heart when an abnormal heartbeat occurs. This shock then corrects irregular heartbeats. Certain advanced type of pacemakers can even sense the breathing rate. This can be helpful during exercise, when the breathing rate increases and the body needs the heart to pump more blood. This makes a person exercise without getting tired or short of breath.

The heart contains a special electrical system that allows it to beat regularly. But in certain conditions such as a heart block, the heart may not beat normally on its own. If the heart rate becomes too slow, it cannot pump enough blood to meet the body’s needs. This causes symptoms such as fatigue, dizziness and shortness of breath. A pacemaker is used to regulate these abnormal heartbeats when the condition is serious and is uncontrolled by drugs.

The patient is given general anaesthesia or local anaesthesia to numb the area for surgery. The doctor makes a small cut in the skin over the upper chest and makes a place for the pacemaker. Then he places a wire into a vein (a blood vessel carrying impure blood) and guides one end into the heart and the other end is connected to the pacemaker.

The patient needs to stay in the hospital for 3-5 days, depending on his condition. The doctor may check the pacemaker with a monitoring device to have a baseline or a starting point with which to compare subsequent checkups. He may also suggest some lifestyle modifications and the expected or average time before the battery in the pacemaker may need to be replaced.

There are certain risks involved with the use of a pacemaker and should be discussed carefully with the doctor. The doctor will advise a pacemaker only if he finds the need outweighing the risks; these include:
 

Infection or bleeding
 

Wire getting dislodged or breaking
 

Worsening of other heart problems related to irregular heart beats
 

The wire may puncture one of the lungs, the vein or the heart cavity
 

A pacemaker, like any other electrical device, may need replacement if it stops working properly.