This paper gives a brief description of pacemaker. It discusses the conditions in which it should be used, prehospital treatment and significance, occurrence, expenses, risks and benefits. Hence it encompasses all the relevant points related to a pacemaker. What is a Pacemaker? Pacemaker is a compact device that is located under the skin of abdomen or chest. It is used to control the abnormal rhythms of the heart. Pacemaker brings in use the electrical pulsation to make the heart beat at a normal rate. Pacemakers are placed in case the heart is beating too fast, slow or irregularly.

The abnormal rhythms of the heart are referred to as arrhythmias. The symptoms of arrhythmias include dizziness, fatigue and lethargy. Pacemaker controls these symptoms up to some level. Pacemakers enable people with abnormal heartbeat rhythms to lead a normal and active life. These devices also have the ability to monitor an individual’s blood temperature, rate of breathing along with other essential factors. It also adjusts the heart rhythms according to the daily activities. Pacemakers are both permanent and temporary.

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Temporary pacemakers are placed to deal with temporary problems such as slow heartbeat which can be due to a heart attack, a surgery of the heart or due to overdose of a drug. Temporary pacemakers are normally used in emergency cases or situations and are used until the implantation of a permanent pacemaker. An individual with a temporary pacemaker has to stay in the hospital till the device is removed. (Mc Grath, Lane, 1998) Condition Pacemaker is used in order to manage the following conditions: • It is used to speed up the slow beating of the heart.

• It assists to bring an end to abnormal or fast rhythms of the heart. • It makes sure that the contraction of the ventricles is normal and that the atria are beating in a normal manner rather than quivering. • It brings the electrical signals of the upper and lower chambers of the heart in coordination. • It also synchronizes the electrical signals between the ventricles. • Dizziness or fainting that is caused due to irregular nerve impulse. This phenomenon is referred to as neurocardiogenic syncope. In this, the heart rhythms of the heart are slowed. • It is used in case the muscles of the heart are diseased.

This is known as cardiomyopathy. • To treat congestive heart malfunctioning. Pacemakers are also used to deal with two very crucial situations. They are as mentioned below: • Sick Sinus Syndrome: In sick sinus syndrome, the sinus node either beats too slow than it normally should and in other conditions, it does not respond at the desired rate, as in the case of exercise. Due to this, the heartbeat slows down and gives rise to dizziness, shortness of breath, faint spells. • Heart Block: In this situation, signals coming from the sinus node are either blocked or there is a delay in the delivery.

These signals are passing from the AV node to the ventricles. (Way, 2008) Pre-Hospital Treatment Before a pacemaker is implanted, several steps are taken. The appointed doctor reviews the medical history of the patient. The allergies and other minor diseases are taken into consideration. The current intake of drugs is examined. The patient is required to stop the usage of such medicines that are used to clot blood. Daily eating and drinking is also stopped for a certain period before the entire procedure is carried out. The prehospital treatment steps that are taken are as mentioned below:

• The patient should be given emotional support. • There should be a proper airway for suction. • The flow of oxygen should be administered. • Cardiac monitor is applied. • Bleeding should be controlled in case there is any. • Proper support should be provided so that the patient is not in a comfortable state. • An appropriate position should be provided so that the patient is comfortable. • Medical Control should be contacted and necessary medicines should be added as per orders. • Transport should be initiated as soon as possible. (Huszar, 2008) Occurrence

The usage of pacemaker is increasing day by day since there is a constant increase in the rate of heart attacks and other cardiovascular diseases. It is being used worldwide. Pacemaker implantation is more common in the Western countries and urban countries as compared to the low and middle income countries. In the United States, approximately 200,000 pacemakers are implanted annually. 175,000 out of 200,000 pacemakers are repaired, replaced or removed each year. According to the report of the US National Institutes of Health (NIH), the standard price of a pacemaker is 10,000 currently.

According to many reports and studies, pacemaker is an expensive yet safe and feasible method of dealing with heart problems. (Bond, 2007) Expense Intrusion of pacemaker is expensive and it involves an operation on the patient. Although it is a safe and expensive device yet there are some risks associated with it. There are 2 types of pacemakers; dual chamber pacemaker and single chamber pacemaker. The price and expenses vary accordingly. Dual chamber pacemakers are more expensive than single chamber pacemaker.

This was the basic concept 12 years ago however with the advancement in technology and competitive revolution in the marketplace, there is so significant difference in the costs of both dual and single chamber pacemakers. 70. 2 and 73. 8 of the respective devices were functioning normally even after 10 years. However studies show that surprisingly the charges of single chamber pacemakers is greater than the cost of dual chamber pacemaker. Risks No matter how advanced and efficient a technology is, there is however some risks and benefits associated to it.

Similarly there are both long term and short term associated with the implantation of pacemaker. They are listed as under: Short Term Risks: • Infection at the site of surgery • Sensitivity to the device; pacemaker • Excessive bleeding • Puncture in the heart muscles • Heart attack or stroke • In severe cases the lungs might get punctured. • Creation of blood clot in the pocket of the skin • The place where the pacemaker is implanted might wear away. • Numb hand or fingers after the implantation of pacemaker. • The patients are required to remain at a safe distance from magnetic and electromagnetic fields.

Long Term Risks: • The electrodes placed inside the pacemaker may dislodge. • There are chances that the tip of the electrode may get fractured. • The insulation that is placed on the pacemaker might break. • Connection that exists between the pulse generator and a pacemaker lead can loosen. • The biggest risk that is associated with the pacemaker is that it might fire at the wrong time. (Stern, 2008) Conclusion With the passage of time, different diseases are prevailing and the most significant and fatal among them is heart disease.

To overcome this problem, several methods are being introduced and implantation of pacemaker is one of them. Pacemaker is a very convenient and efficient method of synchronizing irregular, slow or fast heartbeats. It brings the heart rhythms in accordance with the daily routine. It is placed below the chest skin. There are several risks linked with this technology yet it is being used worldwide due to its effective performance. People normally prefer permanent pacemakers since they are more convenient and pose less threat. The current expense of a pacemaker is 100,000.

Its use in United States is more as compared to any other country. Two types of pacemakers have been discussed in this paper and both have turned out to be effective and are producing good results. References Bond. R. B. (2007) Permanent Pacemaker Implantation. Journal of Emergency and Critical Care. Volume 2. Pages 67-72. July 1 2007. Huszar. J. R. (2008) Emergency Cardiac Care. Michigan: Appleton and Lange. Mc Grath. G, Lane. D. (1998), Pacemaker. Pan Macmillan. Stern. S. (2008) Ambulatory ECG Monitoring. California: Year Book Medical Publishers. Way. L. W. (2008) Current Surgical Diagnosis and Treatment Michigan: Ap