Heart pacemaker

Heart pacemaker is a medical device that generates electrical impulses delivered by electrodes to contract the heart muscles and regulate the electrical conduction system of the heart. The primary purpose of a heart pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or there is a block in the heart's electrical conduction system. Modern pacemakers are programmable and can adjust the heart rate in response to the physical activity of the patient.

History

The development of the heart pacemaker has evolved significantly since the first external pacemakers were introduced. The first implantable pacemaker was developed in 1958 by Arne Larsson and implanted by Åke Senning. This marked a significant milestone in medical history, providing a solution for patients with severe arrhythmia.

Types

There are several types of pacemakers, including:

• Single-chamber pacemakers which stimulate either the right atrium or the right ventricle.
• Dual-chamber pacemakers which stimulate both the right atrium and ventricle, helping to coordinate the timing between the upper and lower chambers of the heart.
• Biventricular pacemakers or Cardiac Resynchronization Therapy (CRT) devices that are used for the treatment of heart failure by coordinating the function of the left and right ventricles.

Indications

Pacemakers are indicated for various conditions, such as:

• Bradycardia - a condition where the heart rate is too slow, leading to inadequate blood flow to the body.
• Heart block - a condition where the electrical signal is delayed or blocked after leaving the SA node.
• Atrial fibrillation with slow ventricular response - a condition where the heart's upper chambers (atria) beat irregularly.

Functioning

A pacemaker works by monitoring the heart's electrical impulses and, if necessary, generating a small electrical impulse that stimulates the heart to beat. The device consists of a pulse generator, which houses the battery and the electronics that control the heartbeat, and one or more leads that transmit impulses to the heart.

Complications

While pacemakers are generally safe, there are potential complications, such as:

• Infection at the implant site
• Lead displacement
• Reaction to the device material
• Interference with the device from external sources

Future Developments

Research is ongoing to develop leadless pacemakers and to enhance the technology to adjust more dynamically to the patient's lifestyle and needs. Innovations such as batteryless pacemakers powered by heart motion are also being explored.

See Also

• Cardiac electrophysiology
• Implantable cardioverter-defibrillator
• Medical device

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