It is common to think of the heart as a pump, a pump that pulses and beats oxygenated blood throughout the body. This four chambered organ is able to carry out its function with the help of electrical impulses that regulate the hearts pumping action. The heart’s ability to know when to contract and pump hinders on a properly functioning mass of specialized cells known as the sinus node, which is located top of the right atrium of the heart. These electrical impulses travel across the heart telling each chamber when to contract and pump, and it is the heart’s natural pacemaker.
Unfortunately, the sinus node does not always function properly in everyone. Sometimes, the heart has a defect and causes the heart to beat too fast (tachycardia), too slow (bradycardia), or it may have an irregular arrhythmia. When this is the case, the heart’s electrical impulse may need to be regulated by an artificial pacemaker. An artificial pacemaker is an electrical device that is powered by battery, and is used to regulate an irregular beating heart. There are different forms of artificial pacemakers, and are either externally used or internally implanted.
The following are different pacemaker methods:
Transthoracic Mechanical Pacing, also known as Percussive Pacing, is a non-invasive pacemaker method. This method uses an actual closed fisted strike to the left lower edge of the sternum, which is an area over the right ventricle. The striking from a 20 cm distance will and should initiate a ventricular beat. Percussive Pacing is an older method of pacemaking, and is not commonly used today.
Transcutaneous Pacing is generally used in emergency situations for people needing to be stabilized from hemodynamically significant bradycardia (slow irregular heart rate). In this method, two pacing pads will be placed upon the person’s chest in the anterior and lateral position. Then the pace will be regulated until an electrical capture is monitored on the ECG. Again, this method of pacemaker is used as a temporary and emergency technique, and not for long term treatment.
Transvenous Pacing is also a temporary method pacemaker, but a more invasive method since it is an internal pacing method. Transvenous Pacing involves introducing a wire, by way of a Central Venous Catheter, into either the right atrium or the right ventricle. The other end of the wire is then attached to pacemaker generator, which will then regulate the electrical impulses of the heart. This method is often used until a permanent internal pacemaker is placed, or as temporary treatments in a person who may not need permanent long-term pacing.
When a person needs more aggressive heart rate regulation, it may be necessary to utilize permanent pacing method, or the implantable pacemaker, which involves placing one, or possibly more, wires within the actual chambers of the heart. The wire ends will be attached to the heart muscles in the chambers, and the other ends of the wire will be affixed to a pacemaker generator. The actual pacemaker generator will be implanted below the subcutaneous fatty tissue in the chest wall area, but above the muscles and bones of the chest region. The generator is what contains the power source, as well as the computer logic, and the outer casing is made of titanium which is less likely to be rejected by the immune system.
The need for a pacemaker will be dependent on the type of pacing the individual person will require. It may be a temporary requirement, or a life-long necessity.