Pacemaker: how do pacemakers work?


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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).

Read also :

⋙ Cardiovascular diseases: how to protect your heart?

⋙ A mammogram to detect heart disease?

⋙ Taking statins before heart surgery reduces the risk of complications


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