Pacemaker: how do pacemakers work?
What is a pacemaker?
Every year, between 60,000 and 70,000 patients are implanted with a pacemaker in France, according to the Haute Autorité de Santé (HAS). " It is estimated that more than 90% of these patients are aged 75 and over "develops Dr. Claude Kouakam, cardiologist.
A pacemaker, what is it exactly? Specifically, a pacemaker is an electronic device that is installed in the pectoral region - left or right, under the clavicle - and is connected to the heart by an electric cable.
The pacemaker consists of a housing (which contains artificial intelligence and electronic components) and a probe (which monitors the heart rate). " It's a device that the cardiologist installs via a small surgical operation under local anesthesia "Dr. Kouakam notes.
The goal? Dealing with heart rhythm failures when it tends to beat too slowly - it's called bradycardia. " Bradycardia is opposed to tachycardiawhen the heart tends to beat too fast "explains the cardiologist.
How does a pacemaker work?
First thing to know: a healthy heart has its own natural pacemaker. " There are specialized cells in the heart that are responsible for sending an electrical pulse to the heart muscle to cause its contraction, at a specific rate, which continuously adapts to the needs of the body says Dr. Kouakam.
problem: in the case of bradycardia, these cells no longer fulfill their function completely. This is where the pacemaker comes in: " the pacemaker, via the probe that collects the electrical signal, continuously monitors the heartbeat. When it approaches the minimum value programmed by the cardiologist - for example, 50 beats per minute in the sedentary senior, 60 - 70 beats per minute in the active person - the pacemaker (via the probe which is directly heart contact) sends a very small electrical pulse (of the order of a few micro-amps!) to the heart muscle to force its contraction ".
What are the indications?
- " In the vast majority of cases, the installation of a pacemaker is linked to the normal aging (or premature) of the electrical circuit of the heartwhich results in bradycardia "explains the cardiologist.
- Some drugs (beta-blockers, anti-arrhythmics ...) can also cause bradycardia requiring the installation of a pacemaker.
- More rarely, a pacemaker may be necessary in case of hypertrophy of the heart, heart failure or congenital malformation.
Live normally (or almost) with a pacemaker, it is possible!
" It is obviously possible to live well with a pacemaker, moreover the president Jacques Chirac has been wearing one since 2008! "Fun Dr. Kouakam.
Of course, wearing a pacemaker still requires regular "check" medical appointments (every 6 months or so). " It is necessary to change the device every 10 years and the probe has a lifespan of about 30 years "the cardiologist said, but it all depends on the use:" sports and / or very active people will probably need more frequent checks ".
On the side of limits, not much to report since "recent pacemakers really allow a lot of activities - most are even compatible with MRI":
- Contact sports (boxing, karate, rugby ...) are not recommended: " this is to avoid repeated blows on the pacemaker housing, placed under the skin ".
- Diving beyond 40 meters is also to be avoided: " the barometric pressure could have a negative impact on the device ".
In general, it is recommended to seek medical advice from your cardiologist before starting a new activity in case of wearing a pacemaker.
5 tips to know about pacemakers
- If the vast majority of pacemakers are for people aged 75 and over, it is also possible to put a pacemaker on a baby - for example, a congenital malformation of the heart muscle.
- The pacemaker is powered by a lithium battery.
- The pacemaker's case is titanium: it is the material best tolerated by the body with a risk of rejection almost zero. In case of allergy to titanium (this is rare), the pacemaker can be made of gold.
- Modern pacemakers can be programmed closer to natural physiology: the cardiologist can program a different minimum heart rate during the day and night.
- The pacemaker only concerns people suffering from bradycardia. In case of tachycardia (or for people who suffer from bradycardia and tachycardia), a defibrillator will be installed instead.
To know : Two major innovations will soon be available to patients: the pacemaker without probe ( ' it is a device that performs exactly the same function as the pacemaker, but there is no big box under the skin: an electronic microchip is simply positioned at the tip of the heart ") and the automated cardiac cell culture ( ' it's about cultivating specialized heart cells and then injecting them back into the heart to "fix" the electrical circuit - it's a biological pacemaker! ").
Thanks to Dr. Claude Kouakam, cardiologist at Lille University Hospital and member of the French Society of Cardiologist (SFC) and some French Federation of Cardiology (FFC).
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