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When the heart needs help to beat

When you are at rest, your heart should beat between 60 to 100 times a minute. But one can develop conditions, like arrhythmia, where the heart beats too fast, too slow or is just irregular. 

Arrhythmia is caused by changes to heart tissue and can be triggered by stress, medicines or imbalances in the blood. When your heart beats irregularly, it may not be able to pump enough blood causing fatigue, shortness of breath or fainting.

A severe arrhythmia can lead to damage of the body’s vital organs or even cause death, and the heart may need help to maintain normal rhythms.

Enters the pacemaker. Since the heart uses an inbuilt electrical system to control the rate and rhythm of your heartbeat, a pacemaker uses electrical pulses to prompt the heart to beat normally.

How it works

“A pacemaker is required in the event that the heart rhythm is disturbed, particularly if it looks like it’s slowing down and in patients who have symptoms related to this,” says Dr Mohamed Jailan, a cardiologist and pacemaker specialist at Aga Khan University Hospital. “This device monitors the heart rhythm and if necessary reminds the heart to beat so that the rhythm problem can be corrected.”

A pacemaker is a small device that is usually placed in the chest to help a patient have a normal lifestyle by monitoring and controlling their heartbeat. It is fitted with a battery, computerised generator and sensors which detect the heart’s electrical activity. When the heart rhythm is abnormal, the sensors send signals to the computer, which then prompts the generator to send pulses to the heart.

This device connects to the heart using some floppy wire and is usually placed under the collarbone in a procedure that takes an experienced cardiologist about 20 – 30 minutes. It is performed under local anesthesia therefore the patient is able to go home the same day.

Pacemakers can increase or decrease a heart rhythm, coordinate electrical signaling between the upper and lower chambers of the heart and also between the ventricles. They can also monitor the heart’s electrical activity, breathing rate and adjust your heart rate to changes in your activity.

Not all patients with rhythm problems need a pacemaker. “Doctors will recommend them for patients who have very slow heartbeats, usually slower than the normal 60 to 100 beats a minute and where drugs cannot work,” says Dr Grace Achiya, a cardiologist at the Hurlingham Medical Centre in Nairobi.

Before recommending a pacemaker, a cardiologist will consider symptoms like dizziness, unexplained fainting, or shortness of breath in a patient. He or she will will examine whether one has a history of heart disease, what medicines they are currently taking, and other test results.

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