Everything You Wanted to Ask about Cardiac Pacemakers

Questions and Answers:

Q: What is a pacemaker?

A: pacemaker is a small device that is placed in the chest so as to deliver low-energy electrical pulses as needed to prompt the heart to beat at a normal rate.

Q: What is the difference between a pacemaker and a defibrillator?

A: A defibrillator is a device that can contain a pacemaker, but it also has the capacity to deliver a higher intensity electric shock and other pacing treatments to the heart to restore a normal rhythm, in case of a potentially lethal arrhythmia.

Q: Who needs a pacemaker?

A: If the native electrical conduction system of the heart becomes defective in some way and the heart rate is so slow that the heart does not supply the needs of the body, a pacemaker can electrically stimulate the heart to beat at an adequate rate.

Q: How would someone know if they are at risk for a dangerous heart rhythm and need a defibrillator?

A: Patients who have had significant damage to their heart after a heart attack or who have severely decreased heart function for other reasons may be at risk for an arrhythmia. Other patients may have a genetic predisposition to dangerous heart rhythms.

If you have reduced heart function or a significant family history of sudden death, you should discuss with your doctor if a defibrillator is the right choice for you.

Q: Can anyone who needs a pacemaker get a leadless pacemaker?

A: The suitability of a patient for a leadless pacemaker depends on the type heart rhythm problem the patient has. Right now the Micra is only implanted into the ventricle, and if someone needs to be paced from both the atrium and the ventricle, this may not be the appropriate choice.  If you need a pacemaker, you can discuss this with the cardiologist.

Q: Can I trade in my device for one of these new ones?

A: Yes indeed. However one would only do this if there is a complication with the current system and you need to have it changed anyway.  These decisions should be made together with a trained pacemaker specialist (electrophysiologist).

Q: Will my cellphone affect the pacemaker?

A: Cellphones do emit radiofrequency energy which can theoretically affect your pacemaker functioning. Modern pacemakers are designed to be resistant to interference from cellphones, but as new more powerful cellphones come out this may need to be reassessed.  As a precaution, we suggest that you do not carry your cellphone in a pocket directly above the pacemaker.  You may wish to hold the cellphone on the other side.

For more information, you should consult with your doctor or a device specialist.

Q: Can a person with a pacemaker use the microwave?

A: The microwaves do not affect the pacemaker and there is no reason why a person with a pacemaker should not use the microwave.

Q: What happens if I need to go through the metal detector?

A: Going through the metal detector is not recommended according to the device manufacturers, however, from experience, it will most likely not affect your pacemaker. Show the security personnel the pacemaker ID card and he will advise accordingly.

Q: Can I do an MRI scan with a pacemaker device?

A: More and more devices have been tested to be MRI safe.

When you are referred for an MRI procedure, tell the doctor that you have a pacemaker so that they can  check if that particular pacing system is designed to be used safely with MRI. You need to undergo the MRI at  a center that has been trained to handle MRIs with devices.

Before your MRI procedure, your device will be checked and programmed to a special mode that will allow for safer performance of the MRI. After your MRI procedure, your device will be programmed back to its previous settings.

Q: What happens if I need surgery?

A: Make sure you tell your surgeon and anesthesiologist that you have a pacemaker, including the make and model of the device. They may need to adjust the pacemaker settings prior to or during the surgery.

Q: What maintenance is required for the new device?

A: In addition to regular checkups with the cardiologist, a patient with a new device needs to visit every 6-8 months  for device follow-up, which includes checking the day to day operation of the device, review of any events and checking whether the device’s battery needs to be replaced. (Generally, the battery is expected to last approximately 7-10 years).