Q: What is a pacemaker? A: A pacemaker is actually made up of two parts. These are the pulse generator and the pacing lead (some systems use one lead while others require two). The pulse generator controls the pacing rhythm and is like the “brain” of the system. It does not issue commands when the heart’s own heart rate is fast, but once the heart rate falls below the pacing frequency, the generator issues commands. The pacing lead enters the heart from the vein and connects the pulse generator to the heart, which acts as a “telephone line” to the heart, transmitting commands to the atria and ventricles. Q: When do I need a pacemaker? A: The human heart is a special “pump” of muscle tissue that beats about 100,000 times a day. The heart has a natural pacemaker, the sinus node, which acts as a command center, sending signals to order the heart to contract. At the same time, the heart has a “telephone line” that transmits commands – the heart’s conduction system. The sinoatrial node sends electrical signals that travel through the conduction system to the atria and ventricles, causing them to contract. Certain pathologies (such as coronary artery disease, myocarditis, etc.) can cause the heart’s “command center” or “telephone line” to malfunction, slowing or even stopping the heart’s contractions. This can cause weakness, dizziness, brief loss of consciousness, and even life-threatening conditions. In this case, a pacemaker is the best option, as it replaces your “command center” or “telephone line” and sends commands to the atria and ventricles, causing the heart to contract in a normal rhythm. Of course, pacemakers can also treat and prevent many other diseases. Q: Is the procedure complicated? A: Pacemaker implantation is a very common procedure today, requiring only local anesthesia. The doctor delivers the pacing lead to the right place in the heart through a vein. After testing that the lead is working well, the doctor connects the pacemaker to the lead, makes a small incision in your forehead, and places the pacemaker under the skin. The whole procedure takes about 1-2 hours. Q: What should I be aware of after the procedure? A: In the early postoperative period (within 24 hours) the patient should lie flat in bed with little activity. After three days, gradually increase the amount of activity. The stitches are usually removed from 1 week to about 10 days after surgery, please do not take a shower during this period. If the wound becomes red, swollen, hot, painful or oozing, especially if you have a fever, please tell your doctor immediately. Avoid sudden and rapid movement of the arm for a few weeks after the procedure to prevent the electrodes from falling off. Q: Is it possible to exercise after the pacemaker is placed? A: You can basically live and work as an ordinary person after the pacemaker is placed, so there is no need to worry too much about it. However, you should avoid too intense exercises and exercises close to the embedded part of the pacemaker such as push-ups. Q: Can I use electrical appliances after the pacemaker is installed? A: General household appliances such as TVs, telephones, microwave ovens, hair dryers, computers, etc. do not affect the pacemaker, but the pacemaker is affected by magnetic forces, so please do not put magnetic objects such as magnets or magnetic therapy devices near the buried part of the pacemaker (magnetic therapy devices can be used safely in other parts of the body). When you have an abnormal sensation when approaching an electrical facility, please leave the device immediately and your pacemaker will resume normal operation. Q: Can I use my cell phone after the pacemaker is placed? A: Mobile phones interfere with the pacemaker. Please do not put your cell phone in your pocket close to the pacemaker. Generally, it is safe to use a cell phone when it is kept above 30 cm from the pacemaker, e.g. when talking with the phone close to the ear on the opposite side from the one in which the pacemaker is buried. If you feel any physical abnormality (dizziness, panic) while using the phone, stop using it immediately and the physical abnormality will be eliminated. Q: Will transportation have an effect on the pacemaker? A: You can safely travel by car, train, ship, airplane, etc. after the pacemaker is placed. Airport security equipment does not affect the pacemaker, but since the pacemaker is metal, you should show the pacemaker implant card to the airport staff. Also, do not put your body near the engine when the hood of the car is open. Q: Should the pacemaker be checked regularly after implantation? A: It is essential to check regularly how the pacemaker is working and whether it is working according to your needs. Your doctor will usually ask you to come to the hospital in the second week after discharge to check the healing process, and you should be followed up every one to three months thereafter. The follow-up visits should be intensified when the pacemaker is reaching the end of its life. In addition, you should contact your doctor promptly if there are any abnormalities. Since certain medical devices, such as MRI and electrosurgery, can affect the pacemaker, it is important that you tell your doctor that you have a pacemaker at the time of your visit. We issue a pacing follow-up card to each patient who has a pacemaker placed, so please bring it with you during your visit. Q: What is pacemaker programming? A: Today’s pacemakers are well-designed and the operating conditions of the pacemaker (i.e. pacing parameters), such as pacing frequency, voltage, etc., can be adjusted outside the body. At the follow-up visit, the physician can use a machine called a “programmer” to obtain information about the pacemaker’s operation without trauma and adjust the parameters to better suit your needs. This is called “program control”. The process is as painless and convenient as remote control of a TV set. Q: How long does a pacemaker last? A: The battery life of a pacemaker varies according to the disease condition and the type of pacemaker. The battery does not run out suddenly and the frequency set by the pacemaker decreases close to the replacement time, so you can sometimes predict this by checking your pulse. Of course, you should follow up more closely when it is close to replacement. In addition to battery depletion, other parts of the pacemaker also have a life span, so we recommend replacing the pacemaker after its useful life for your safety. Q: Is it possible to recharge the pacemaker battery after it has been depleted? A: No. In the current situation, pacemakers should be replaced after their age. If the lead is in good working order, replacement is simply a matter of cutting open the pacemaker capsule and replacing it with a new pulse generator. If the lead is tested to be faulty, a new pacing lead should be implanted as in the first pacemaker placement. Q: Why do I need to take medication after pacemaker placement? A: The pacemaker ensures that the heartbeat does not fall below the pacing frequency, but it does not cure all heart diseases, such as coronary heart disease and premature beats. Therefore, your doctor may ask you to continue taking some medication after the pacemaker is implanted in order to treat the underlying heart disease.