Description

Pacemaker Application

How are pacemakers inserted?

Pacemakers are divided into 2 according to the purpose of insertion:

temporary pacemaker

Temporary pacemakers are used in emergencies or when the underlying cause of the abnormal
heart rhythm is expected to resolve (eg, slow heartbeat due to medication). It
is also used to maintain adequate heart rate until a permanent pacemaker is
implanted. Temporary pacing may also be required in heart attack patients,
patients with tachycardia, after open heart surgery and in other situations.

In temporary pacemakers, the generator is quite large and is outside the body. The
cable (lead) provides the connection with the heart. Since it is
temporary, it cannot be left for a long time. If the event is thought to
be permanent, it is removed and a permanent pacemaker is inserted.

permanent pacemaker

It is used in cases where the event requiring battery insertion is considered
permanent. The generator is placed on the chest or abdomen by creating a
pocket under the skin. However, it is mostly placed on the left side of
the chest wall. If it is to be placed on the chest wall, patients may be asked
to choose which side to place the battery.

How is a pacemaker inserted?

Informed consent is obtained from the patient or their relatives for battery placement.

Temporary pacemaker placement

Temporary pacing is usually performed while patients are hospitalized for associated
heart conditions (eg following a heart attack). The procedure is performed
in the patient’s room or in the catheter laboratory. A small sheath is
placed in the neck or groin area after the sedative (if necessary) and topical
anesthetic are applied. The cable coming from the generator is passed
through this sheath and delivered to the heart. If necessary, the
placement of the cable in the appropriate place in the heart is provided by
x-rays (scopy). The external pacemaker is fixed in a suitable place. Patients
should not touch this unit and should limit their activities while the
temporary battery is in use.

In rare but necessary cases, a temporary pacemaker is connected to the heart with
a needle through the patient’s chest wall or, more rarely, through the
esophagus.