A pacemaker is a small electronic device that is implanted in the chest or abdomen to help regulate the heart’s electrical activity and maintain a regular heartbeat. It is commonly used to treat certain heart rhythm disorders, such as bradycardia (a slow heart rate) or heart block (a disruption in the electrical signals that control the heart’s rhythm).
The pacemaker consists of two main components:

  1. The generator -The generator contains the battery and electronic circuitry that monitors the heart’s rhythm and delivers electrical impulses as needed.
  2. One or more leads (wires)- The leads are thin, insulated wires that are threaded through a vein into the heart. These leads sense the heart’s electrical signals and deliver the electrical impulses from the generator to stimulate the heart muscle and regulate the heartbeat.

How does a pacemaker work?

  • Sensing: The pacemaker constantly monitors the electrical activity of the heart using the leads.
  • Analysis: The pacemaker’s circuitry analyses the electrical signals it receives from the heart.
  • Decision-Making: If the pacemaker detects an abnormality or a deviation from the desired heart rhythm, it initiates appropriate actions based on its programming.
  • Stimulation: When needed, the pacemaker sends low-energy electrical impulses through the leads to the heart muscle. These impulses travel to the heart’s natural electrical pathways and stimulate the heart to contract, thereby regulating the heartbeat.
  • Adjustment: Pacemakers can be programmed and adjusted by medical professionals. They can set various parameters, such as the minimum heart rate, sensitivity levels, and response to specific situations, to meet the individual needs of the patient.
  • Monitoring: Pacemakers also have the capability to store information about the heart’s activity. This data can be retrieved during follow-up appointments with the cardiologist to evaluate the pacemaker’s performance and make any necessary adjustments.

Types of Pacemaker

Based on different heart conditions and patient needs, following types of pacemaker are available:

  1. Single-Chamber Pacemaker
  2. Dual-Chamber Pacemaker
  3. Biventricular Pacemaker (Cardiac Resynchronization Therapy or CRT)
  4. Rate-Responsive Pacemaker
  5. Implantable Cardioverter Defibrillator (ICD)
  6. Leadless Pacemaker


Pacemaker surgery is recommended in following cases:

  1. Bradycardia(slow heart rate)
  2. Heart Block
  3. Sick Sinus Syndrome(abnormalities in heart’s natural pacemaker)
  4. Heart Failure
  5. Arrhythmias

Guidelines for proper functioning of pacemaker:

  • Follow Medical Instructions regarding pacemaker care, including activity restrictions, medications, and follow-up appointments.
  • Incision Care such as keeping it covered and changing dressings as directed.
  • Medication Management includes taking any prescribed medications as instructed by your healthcare provider.
  • Electromagnetic Interference (EMI) should be minimized from exposure to strong electromagnetic fields and devices that may interfere with the functioning of your pacemaker.
  • Cell Phones and Electronics kept at least 6 to 12 inches away from your pacemaker to minimize any potential interference.
  • Follow-Up Appointments
  • Physical Activity: It is advisable to consult your healthcare provider regarding any specific activity restrictions or guidelines based on your condition and the type of pacemaker you have.
  • Report Changes or Symptoms such as dizziness, fainting, irregular heartbeats, or discomfort around the pacemaker site.