In patients who experience fatigue, dizziness or fainting due to a slow heartbeat, a mechanical generator called a pacemaker is necessary to pace the heart to allow normal blood flow. Pacemakers are small computers that are about the size of two stacked half-dollars. The generator, which is placed under the skin by the left or right collarbone, is attached to either one or two small wires that are placed in the vein and the right side of the heart. Pacemakers are programmed by the physician and the batteries usually last 5-10 years.
A patient who needs a pacemaker will be admitted to the hospital. In the electrophysiology laboratory under conscious sedation, the pacemaker generator is placed under the skin. Veins that run underneath both sides of the collarbone are used to access entry to the right side of the heart. The wires are placed in these veins, called subclavian veins. The wires are then attached to the generator and the wound, which is about 4 centimeters long, is closed and the patient stays overnight in the hospital.
After a pacemaker is placed, there are few limitations for the patient other than decreased movement of the arm on the side where the pacemaker was placed for 1-2 weeks. Pacemakers are covered in titanium which prevents abnormal function from environmental electrical signals. Patients with pacemakers can use household appliances, cellular telephones and microwave ovens. Large magnetic fields can be dangerous for pacemaker patients, such as during an MRI, but CT scans, ultrasounds and other medical imaging devices are still allowable after receiving a pacemaker.