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A pacemaker is a small device that's placed in the chest  to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate.

During an abnormal rhythm  the heart may not be able to pump enough blood to the body. This can cause symptoms such as fatigue (tiredness), shortness of breath, or fainting. Severe brady arrhythmia - slow heart rate or heart blocks  can damage the body's vital organs and may even cause loss of consciousness or death.

A pacemaker is designed to mimic the heart’s natural pacemaker, the sinus node. The pacemaker has two main purposes :

  1. Pacing: A pacemaker will send an electrical impulse to the heart through a pacing lead when the heart’s own rhythm is too slow or interrupted. This electrical impulse starts a heartbeat.
  2. Sensing: A pacemaker will also “sense” (monitor) the heart’s natural electrical activity. When the pacemaker senses a natural heartbeat, it will not deliver a pacing pulse.

Traditional cardiac pacemaker systems generally include a subcutaneous pulse generator placed in the chest wall and transvenous pacing leads affixed to myocardial tissue.

Depending on your heart condition, your doctor will prescribe either a single- or dual-chamber pacemaker. This refers to the number of heart chambers that need to be paced or sensed.

For single-chamber pacing, either the right atrium (upper chamber) or the right ventricle (lower chamber) is paced. Only one pacing lead is used.

For dual-chamber pacing, both the right atrium and right ventricle are paced by  two pacing leads. 

PROCEDURE : The procedure is performed under local anesthesia .A small incision, approximately 2 inches long will be made in the upper chest. One or two leads (thin insulated wires) will be guided through the vein into the heart.The electrophysiologist  will then connect the lead(s) to your pacemaker and program it as per  your medical needs.The pacemaker is inserted beneath your skin, and the incision in your chest will be closed.