Today’s pacemakers are 21st century marvels

Pacemakers have been around for more than 50 years, but today’s pacemakers are marvels of technology, with a variety of features that make them safer and more convenient than ever before.

Pacemakers deices use electrical pulses to prompt the heart to beat at a normal rate. They are used to treat arrhythmias, or problems with the rhythm of the heart. During an arrhythmia, the heart can beat too fast, too slow or with an irregular rhythm.

The primary reason most people get a pacemaker is to increase the heart rate to prevent fainting, fatigue and shortness of breath. The need for a pacemaker is most often caused by bradycardia, in which the heart rate is slower than normal, usually the result of damage from a heart attack, aging, certain illnesses or medications, or a hereditary heart defect.

A pacemaker consists of a pulse generator and one or more electrical wires. The wires have sensors called electrodes on one end to detect your heart’s electrical activity and report that data to the pulse generator. The pulse generator sends electric signals through the wires to deliver the energy necessary to create a heartbeat.

Installing a pacemaker does not require open-heart surgery. The procedure takes an hour to an hour and a half. Most patients go home within 24 hours.

Pacemakers hold up quite well. The batteries that run them can last for up to 10 years.

Pacemakers have sensors that can tell if the patient is breathing faster or moving. An accelerometer can speed up the heart rate to accommodate the sensed increased in activity. Patients are able to feel great and do more — even train for an ultra marathon.

Technological advances in today’s pacemakers include remote monitoring. Patients go home with a box the size of a portable speaker, which they connect to a standard electrical outlet in their bedroom. If there’s a problem with the pacemaker or the heart, the pacemaker can communicate with the remote monitoring device and report this information to the patient’s care team, generally within one day.

In newer models, pacemakers can tell us how active our patients are daily and how often they have other rhythm disturbances, including atrial fibrillation. These features allow us to promptly act on important rhythm disturbances, which can reduce significant complications.

For years, patients who had pacemakers could not undergo MRIs because of the metal contained in the device. That has changed dramatically. The metal alloys in current pacemakers are mostly compatible with MRIs. The majority of patients with the newest devices can safely get an MRI — without missing a beat.