Often a pacemaker is surgically implanted to help the heart beat at a normal rate when you have bradycardia. A pacemaker is a small, battery-powered device that generates an electrical impulse in the heart. The pacemaker is programmed by your doctor to cause your heart to beat a certain number of times each minute.

Dual-chamber pacemakers are often used to treat a slow heart rate. This type of pacemaker sends electrical impulses to and receives them from both the upper chamber (atrium) and lower chamber (ventricle) of the heart and paces both chambers. A dual-chamber pacemaker synchronizes the rhythm of the atria and ventricles in a pattern that closely resembles the natural heartbeat.

Most new pacemakers are rate-responsive, or physiologic, pacemakers. This type of pacemaker can vary its rate to beat faster when you are exercising to meet your body's needs. Another type, the fixed-rate pacemaker, sends electrical impulses at a fixed rate when your heart rate is slower than the fixed rate.

Because there are many different types of pacemakers, your doctor will work with you to decide what kind will be best for you.

Inserting a pacemaker is considered a minor surgical procedure. It can usually be done using local anesthesia. Your doctor will make a small incision in your chest wall just below your collarbone. He or she then usually threads the pacemaker wires (leads) through the incision into a large blood vessel in the upper chest and into the heart. Your doctor uses X-rays to place the leads in the heart. Using the same incision, your doctor creates a small pocket under the skin to hold the pacemaker. He or she then attaches the leads to the pacemaker. See a picture of pacemaker placement. The entire procedure usually takes about 1 hour.

Heart problems: Living with a pacemaker or ICD

What to Think About

About twice a year your doctor will check your pacemaker and adjust it, if needed. In between checkups, you may be asked to send information from your pacemaker to your doctor or clinic over the telephone (telephone monitoring).