A pace maker is a small instrument which resembles like a half dollar piece and is place beneath the skin to direct the heart rate. The process of pacemaker implantation is called as ‘Cardiac Resynchronization Therapy’

The motive for pacemaker implantation is many, but the most common one is ‘Arrhythmias’ where the heart rhythm is abnormal. The age of the person makes the heart to function very slowly. Heart attack is also one of the reasons for deliberate heart rate. Intake of certain kind of medications and few genetic forms also cause irregular heart beat.

Importance of Pacemaker Implantation:


The pacemaker is implanted to organize the heart beat regularly. It is fixed provisionally to manage the slow heart rate because of the heart attack or surgery or high dose of drug intake. It is also fixed enduringly in case of Bradycardia or heart collapse.

How does it work?

Natural Pacemaker is the cluster of cells which act like a electric plug that generates electrical impulses which travel through the specialized muscle fibers. The impulse first reaches the right and the left atria making it to contract and squeezes the blood into the left and the right ventricle which supplies the blood to all parts of the body.

The artificial pacemaker impersonate the work of the natural one and it consist of the following parts,

Pulse generator:

It is tiny metal container which has a battery and the electrical circuit which normalizes the electrical pulses sent to the heart.


About one three flexible insulated wires are each placed inside the chambers of the heart which delivers the electric pulses to adjust the heart rate.

The pacemaker monitors the heart rate and if it is very slow the pacemaker will boost it up by sending the electrical impulse to the heart. The pacemaker has sensors which detects the body movement and stimulates it to increase the heart rate during physical activities to meet the body’s increased need for blood and oxygen.

Types of Pacemaker:

  • Single chamber pacemaker:

Only one wire is placed inside the chamber of the heart.

  • Dual/ Biventricular pacemaker:

Wires are placed in two of the chambers of the heart, one in the atria (Upper chamber) and other in the ventricle (Lower chamber). It directs and co-ordinates the work of both atrium and the ventricle thus making more innate pacing of the heart.

  • Triple chamber pacemaker:

It has one wire placed in the right atrium and another one to excite both the right and left ventricles. It is mainly helpful for patients who have heart weak muscles.

  • Permanent/Internal Pacemaker:

This type of pacesetter stays inside the body forever and is kept beneath the skin.

  • Temporary/External Pacemaker:

It is used initially for the stabilization during cardiac problems and is not permanent.

  • Demand Cardiac pacemaker:

This form has the sensor inbuilt in them and it senses when the heart beat is too slow and turns the signal. When the heart beat is normal the signal will turn off automatically.

How Pacemaker Implantation is performed?

It is done under local anesthesia as a daycare procedure. A small cut is made beneath the collar bone. A blood vessel is identified and the pacemaker is inserted into it which is directed towards the heart. Once the lead is fixed it is tested out to make sure whether it is positioned firmly and functioning properly. It is then attaché to the initiator which is fixed under the skin through the cut that is made earlier. The patient rest for few hours and observed for few hours and if he/she is stable they are allowed to discharge from the hospital.