A pacemaker is a small medical device that helps control abnormal heart rhythms. It’s most commonly used when the heart beats too slowly.

What it does

A pacemaker sends tiny electrical impulses to the heart muscle to keep it beating at a normal rate and rhythm. Think of it as a backup timing system that steps in when your heart’s natural electrical signals aren’t working properly – in the majority of patients the pacemaker is programmed to only work when necessary and to simply monitor during times that the heart rhythm is working normally. This has a further benefit of prolonging the life of the pacemaker’s battery.

• The device is usually implanted under the skin near the collarbone.
• Thin wires (called leads) connect the pacemaker to the heart.

Why someone might need one

Doctors may recommend a pacemaker for:

• A slow heartbeat (bradycardia) 
• Fainting spells caused by irregular rhythms
• Certain types of heart block (where the heart beat isn’t regularly transmitted to the main pumping chambers, the ventricles)
• Some cases of heart failure

Types of pacemakers

• Single-chamber: stimulates one part of the heart (either top or bottom chamber)
• Dual-chamber: coordinates top and bottom chambers
• Biventricular (cardiac resynchronization therapy): helps both sides of the heart beat in synchrony

• A conduction system pacemaker is a newer type of heart pacemaker that stimulates the heart’s natural electrical wiring system directly, rather than pacing the heart muscle in a more general way.

• What makes it different Your heart already has its own electrical network—called the cardiac conduction system—that controls how each heartbeat spreads. Traditional pacemakers usually stimulate the right ventricle, which can sometimes create a less natural pattern of contraction (this is fine for many patients, and is well proven over many years).

Advantages

• More natural heart activation pattern
• Can improve heart efficiency compared to standard pacing for some patients with particular issues – your expert clinician will discuss the merits of this with you
• May reduce long-term complications linked to traditional pacing

Limitations

• More technically challenging to implant
• Not suitable for every patient
• Requires a specialist trained in this technique

Everyday life with a pacemaker

Most people live normal, active lives with one. The device is battery-powered and regularly checked by doctors to ensure it’s working properly.